- incomplete: The webbing appears only partially between the digits.
- complete: The skin is connected all the way up the digits.
- simple: The digits are connected by only soft tissue (i.e. skin).
- complex: The digits are joined together with soft and hard tissue, such as bone or cartilage.
- complicated: The digits are joined together with soft and hard tissue in an irregular shape or configuration (i.e. missing bones).
The medical term for webbing of the fingers or toes is syndactyly. Webbed fingers and toes occur when tissue connects two or more digits together. In rare cases, the fingers or toes are connected by bone. According to the Boston Children’s Hospital, one in every 2,500 babies is born with webbed fingers or toes, making this a fairly common condition. (BCH, 2012) Webbing of the fingers or toes is most common in Caucasian males.
There are several different types of webbing that can occur between the fingers and toes. They are:
When a child is developing in the womb, the hand initially forms in the shape of a paddle. Then, around the sixth or seventh week of pregnancy, the hand begins to split and form fingers. In the case of webbed fingers and toes, this process is not completed successfully, leading to digits that are fused together.
In most cases, webbing of the fingers and toes occurs at random, for no known reason. Less commonly, webbing of the fingers and toes is a result of an inherited trait. Webbing can also be related to genetic defects, such as Down syndrome and Apert syndrome. Both syndromes are genetic disorders that can cause abnormal growth of the bones in the hands and feet.
Though every case is different, webbed fingers and toes are always treated with surgery. Surgery is done under general anesthesia, which means your child will be given a combination of medications to put him or her to sleep. Your child should feel no pain nor have any memory of the surgery. This surgery is usually performed on children between the ages of 1 and 2. This is when the risks of anesthesia are lower.
During surgery, the webbing between the fingers or toes is split evenly—in the shape of a Z. In some cases, extra skin is needed to completely cover the newly separated fingers or toes. If this happens, skin may be removed from the groin to cover these areas; this procedure is called a skin graft. Often only two digits are operated on at a time. Depending on your child’s particular case, several surgeries may be needed for one set of digits.
After surgery, your child’s hand or foot will be in a cast. The cast stays on for about three weeks before it is removed and replaced with a brace. A rubber spacer may also be used to help keep your child’s fingers or toes separated while he or she sleeps. It’s also likely that your child will undergo physical therapy after surgery to help with things like stiffness, range of motion, and swelling.
Your child will need to have regular doctor’s appointments to check the progress of his or her fingers and toes. During these checkups, your child’s doctor will make sure that the incisions have healed properly. The doctor will also decide whether your child will need additional surgeries.
Thankfully, after surgery most children are able to function normally with their newly separated digits. Working with the team of doctors assigned to help your child is important in making sure that you and your child achieve the best possible results.
It’s unlikely, however, that surgery will give your child the appearance of a completely normal hand or foot. This may cause self-esteem problems for your child. You might find it hard to cope with your child’s abnormality as well. Your doctor may be able to recommend other families in your area or local support groups whose members understand what you and your child are going through.