Pediatric Orthopedic Surgeons treating webbed toes

WEBBED TOES

 

Webbed toes are the informal and common name for syndactyly affecting the feet — the fusion of two or more digits of the feet.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.

Webbed Toes

Webbed Toes or Syndactyly is a condition that causes fused toes or fingers. It is a common birth abnormality. Researchers do not understand precisely what is causing webbed digits. However, in some cases, it is obvious that there is a definite genetic reason. Usually, Our surgeons correct webbed digits when kids are quite young. It is a suitable phase to prevent related complications. In most cases, the corrective surgeries are successful, giving the child full functional use of their digits. The operated area also appears normal.

What are the Causes?

Webbed Toes or fingers are one of the most common birth abnormalities. It occurs when, during fetal development, the toes or fingers do not separate correctly. However, Syndactyly can also occur after a significant injury, such as a burn. With burns, the skin does not heal properly. People often refer to the condition as webbed toes or fingers because this condition often shows up as webbing. Even though, in most cases, webbed toes occur when the skin does not separate properly, more severe cases may also involve other parts of the body, such as bones, blood vessels, muscles, and nerves.

Syndactyly might show up as a symptom of a syndrome or medical condition. However, most cases are non-syndromic with no apparent cause. There are three hundred different syndromes related to syndactyly. And most of them are genetic conditions such as Down syndrome, Apert syndrome, Crouzon syndrome, etc. According to researchers, there is a well-established genetic basis for certain types of syndactyly. Also, most of them would consider webbed toes an inherited condition. However, researchers have not yet discovered all the factors that can cause this condition to develop. It has become even more difficult because each case is different.

The available research reports that boys have more chances to develop syndactyly than girls. Also, it reveals that Caucasian children have more chances to develop webbed digits than children from other ethnic backgrounds. Syndactyly most commonly develops between the second and third toes even though this condition can affect any toes.

Different Types of Webbed Fingers and Toes

‌‌In each person webbed fingers or toes develop differently. Also, each has a unique genetic makeup that influences the type and severity of syndactyly. Syndactyly refers to skin webbing. But in terms of the condition of the skin, bone, and connecting tissues, there are variations.

According to the researchers, there are four categories of syndactyly depending on hand or foot symptoms:

  • Simple Syndactyly: It is a type in which toes or fingers are joined together with skin and other soft tissues.
  • Complex Syndactyly: In this condition, along with skin and other soft tissues, also some bones are fused under the skin.
  • Complicated Syndactyly: It is a category in which a person has extra or missing bones or bones that are not fully developed. Also, there are abnormal tendons and ligaments in the affected area.
  • Incomplete Syndactyly: Here, only part of the skin between fingers and toes is webbed.

Syndactyly Types Depending On The Affected Fingers Or Toes

Type 1. It is the most common type of webbing found between fingers and toes. However, it is not relevant to other genetic syndromes. Often the third and fourth fingers are webbed or the second and third toes. This type of webbing generally affects both hands or feet.

Type 2. This type of webbing is usually common in the third and fourth fingers and the fifth toe. People with this type of webbing often have extra toes or fingers. In this case, the fifth finger is often crooked, curved, or shortened.

Type 3. This condition generally affects the fourth and fifth fingers of the hands. Also, the third or middle finger might be adjoined, missing, or has not developed fully. This type of syndactyly does not affect feet.

Well, there are many other types of syndactyly that affect the skin and bones of fingers and toes. Our doctor will be able to diagnose the severity and type of a child’s webbed toes by using physical exams, X-rays, or also genetic testing might be necessary.

How Common Are Webbed Toes or Fingers?

‌Syndactyly is a common birth defect. However, if there is no family history of webbed toes and fingers, having a child with this condition might be a little surprising.

Recent research reports that about one in every two thousand to three thousand newborns have webbed fingers or toes. Type 1, which is the most common usually only affects the skin and soft tissues. Other types, including those caused by genetic syndromes with other serious health effects, are much rarer.

As found in about half of babies born with the condition, Syndactyly usually affects both hands. Caucasian male babies are born with webbed fingers and toes more often than female, Black, or Asian babies.

What are the Main Symptoms?

Each person with Webbed Toes experiences different symptoms because this condition may be:

  • Severe, moderate, or mild: The digits may be almost entirely fused, partially fused, or there might be only minor webbing between the toes.
  • Symmetric or asymmetric: This condition may appear the same or different on both sides of the body.
  • Unilateral or bilateral: It impacts only one side or both sides of the body.
  • Painful or asymptomatic: For some, this condition may be painful, while for others, it may not have any symptoms.
  • Simple or complex: It can involve only two digits, or a few bones, or include multiple digits or bones.

In minor cases, children may not experience any interference with toe or foot movement and functionality. However, the condition can be disabling if the toes are severely webbed or fused.

Diagnosis 

In most cases, pediatric orthopedic surgeons can correct webbed toes surgically. And doctors recommend this surgery between the ages of 12 and 18 months before full development takes place. According to experts, it is best to correct webbed toes before it causes any joint malformation. Our doctors will suggest an X-ray or ultrasound of that area for determining the structure and the most effective surgical approach for correction.

They may also suggest doing blood tests, and chromosomal tests to determine whether the webbing is related to another syndrome or condition. It is often advisable, especially when a child also has other physical signs of a syndrome. The surgical approach to correct webbed toes will depend on the severity of the webbing and the underlying structures.

Surgery

Even though every case of webbed fingers or toes is different, the only treatment is surgery. Doctors perform surgery under general anesthesia. That means our surgeons will give your child a combination of medications to put them to sleep. Your child will not feel any pain or not have any memory of the surgery. Experts perform the surgery on young children because, at this phase, anesthesia-related risks are lower. During surgery, the surgeons evenly split the web between the fingers in the shape of Z. Surgeons might need extra skin to cover the newly separated toes. In such cases, they will take the skin from the groin area. Children might need multiple surgeries to operate on one set of digits. However, that will depend on the specific case of the child.

Post-Surgery Recovery

After surgery, doctors will place the hand of the child in a cast. The cast will stay on for at least three weeks. Then the child will have to wear a brace. Experts may recommend using a rubber spacer to help keep the toes separated while they sleep. Children may also require physical therapy after surgery to fix things like stiffness, range of motion, swelling, etc. Make sure your child keeps regular appointments with us to check the healing progress of their operated toes. During the checkups, the doctors will ensure that the incisions are healing properly. A child might need additional surgeries to avoid web creep.

Final Words 

The best thing is after surgery, most children function normally and use their newly separated digits without any problem. However, the fingers or toes that went through the surgical procedure might look different from the others. To avoid any relevant complications, keep in touch with the doctors.
 

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at four convenient locations: Arlington, Dallas, Frisco and McKinney.