What is syndactyly?

Syndactyly is the presence of webbed fingers or toes. It’s a condition that occurs when the skin of two or more fingers or toes is fused together.

In rare cases, your child’s fingers or toes could be joined together by one or more of the following:

  • bone
  • blood vessels
  • muscles
  • nerves

Syndactyly is present at birth. The condition affects about 1 in every 2,500 babies. It occurs most commonly in Caucasian and male babies. Webbing occurs most frequently between a child’s middle and ring fingers.

Syndactyly can interfere with the normal function of your child’s hand or foot.

Unless webbing is minimal, their doctor will probably recommend surgery to correct the condition. Webbed toes may not require treatment if the webbing doesn’t 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.

About 10 to 40 percent of syndactyly cases are caused by an inherited trait.

Webbed fingers and toes can occur as part of an underlying condition, such as:

In other cases, webbed digits occur on their own for no apparent reason.

Surgical opinions differ about when it’s best for a child to have syndactyly surgery. However, most experts agree that your child should be at least a few months old before having this surgery.

Choose a trusted surgeon to perform the surgery and ask them about the ideal time frame to schedule the procedure for your child.

It’s important for your child’s syndactyly to be treated before they begin missing developmental milestones that involve their fingers, such as grasping objects.

Your child will probably receive general anesthesia, so that they’re asleep during the surgery. A series of zigzag incisions will be made to separate their fused fingers or toes. It’s a procedure is called Z-plasty.

During Z-plasty, incisions will split the excess webbing between your child’s fingers or toes. Their surgeon will likely use pieces of healthy skin from another part of your child’s body to cover the separated area. This is called a skin graft.

Separating your child’s webbed or fused fingers or toes will allow each digit to move independently. This procedure is intended to restore full functionality to your child’s hand or foot.

If your child has more than one area of webbing, their surgeon may recommend multiple surgeries to minimize their risks.

After surgery to repair their webbed fingers or toes, your child’s hand or foot will be placed in a cast for about 3 weeks. The cast will help keep their hand or foot immobilized. It’s important that their cast is kept dry and cool. It’ll need to be covered when you give 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 their recovery.

Your child’s surgeon may also recommend physical or occupational therapy to improve their chances of full functionality in their fingers or toes. Their doctor will also suggest a series of follow-up visits to monitor your child’s healing.

It’s possible that your child may experience mild to moderate effects of syndactyly repair surgery, but this is rare.

Potential negative effects of the surgery can include:

  • extra skin growing back, which is called “web creep” and must be repaired again
  • hardening of scar tissue
  • problems with the skin graft used in the surgery
  • changes to the appearance of the affected fingernail or toenail
  • a lack of adequate blood supply to the finger or toe, which is known as ischemia
  • infection

See your healthcare provider immediately if you notice any abnormalities or color changes in your child’s fingers or toes.

After surgical repair of finger or toe syndactyly, your child will most likely experience normal finger or toe function. Their hand or foot will also show a difference in appearance now that with the digits moving independently.

If your child experiences complications, additional surgeries may be necessary to help them gain full function of their fingers or toes. Additional surgeries to improve the appearance of their hand or toes can also be arranged for a future date.

Your child’s hand or foot will continue to grow normally after the surgery. Some children may require additional surgery when they reach adolescence, after their hands and feet have grown and fully matured.