Webbed Fingers or Toes (Syndactyly)
Webbed fingers and toes, formally called syndactyly, is a condition that occurs when two or more fingers or toes are fused together by skin. In rare cases, the fingers or toes could be joined together by bone, blood vessels, muscles, or nerves.
This condition is present at birth. According to the Boston Children’s Hospital, syndactyly affects about one in every 3,000 babies, most commonly Caucasians and males. Webbing occurs most frequently between a child’s middle and ring fingers (CHB, 2012).
This condition can interfere with the normal function of your child’s hand or foot. Unless the webbing is minimal, the parents of a child with syndactyly of the fingers usually decide to repair the condition through surgery. Webbed toes may not require treatment if the webbing does not interfere with the function of your child’s foot.
Webbed fingers and toes can sometimes be detected before your baby is born through an ultrasound exam. However, prenatal indications of syndactyly may not be completely accurate (Bae, Barnewolt, & Jennings, 2009).
Repairing Webbed Fingers or Toes with Surgery
Surgical opinions differ as to the earliest a child should have syndactyly surgery. However, most agree the child should be at least a few months of age. Choose a trusted surgeon to perform the surgery and discuss with him or her which time frame is best for your child. It is important for your child’s syndactyly to be treated before he or she begins to miss developmental milestones that involve the fingers, such as grasping objects.
If your child has more than one area of webbing, his or her surgeon may recommend multiple surgeries to minimize the risk of complications.
This type of surgery usually involves putting the child under general anesthesia, so he or she is asleep during the surgery. Then, a series of zigzag incisions (z-plasty) are made to separate the fused fingers. These incisions split the excess webbing between your child’s fingers or toes. Usually, the surgeon will then use a small amount of healthy pieces of skin from another part of the body to cover the separated area. This is called a skin graft.
The separation of the webbed or fused fingers will allow each finger to move independently. This procedure is intended to restore full functionality to your child’s hand.
Recovering from Surgery
After surgery to repair webbed fingers or toes, your child’s hand or foot will be placed in a cast for about three weeks. The cast will help to keep the hand or foot immobilized. It is important that the cast be kept dry and cool. It will need to be covered when giving your child a bath.
When the cast is removed, your child may then wear a splint for several more weeks. The splint will continue to protect the repaired area during recovery.
Your child’s surgeon may also recommend physical or occupational therapy to improve the chances of full functionality of the fingers or toes. He or she will also suggest a series of follow-up visits to monitor your child’s healing.
Possible Complications of Surgery for Webbed Fingers or Toes
In rare cases, it is possible for your child to experience mild to moderate complications after syndactyly repair surgery. Potential negative effects of the surgery could include:
so-called “web creep,” in which the extra skin grows back and must be repaired again
hardening of scar tissue
problems with the skin graft used in your child’s surgery
changes to the appearance of your child’s affected fingernail
lack of adequate blood supply to your child’s finger, known as finger ischemia
See your doctor immediately if you notice any abnormalities or color changes to the fingers or toes.
What Is the Outlook for Surgical Repair of Webbed Fingers or Toes?
After surgical repair of finger syndactyly, your child will most likely experience normal finger function. The hand will also have an improved appearance. If there are complications, additional surgeries may be necessary for your child to have full function of the fingers or toes. Additional surgeries to improve the appearance of the hand or toes can also be arranged for a future date.
Your child’s hand will continue to grow normally after the surgery. Some children may require additional surgery when they reach adolescence, after their hands have fully matured and grown.