Repair of webbed fingers or toes

Alternative names
Web finger repair; Web toe repair; Syndactyly repair

Definition

The repair of webbed fingers or toes is corrective or reconstructive surgery to repair syndactyly, which can affect toes, fingers, or both. The middle and ring fingers or the second and third toes are most often affected.

Simple syndactyly involves only the skin and other soft tissues. Complex syndactyly involves fused bones, nerves, blood vessels, and tendons. Generally, syndactyly repairs are done between the ages of 6 months and 2 years.

Description

General anesthesia is used. Skin areas to be repaired are marked. The skin is cut, and small flaps at the sides of the fingers or toes and in the web are lifted up. These flaps are sewn into position, leaving absent areas of skin. These areas may be filled in with full-thickness skin grafts taken from the skin in the groin area, if necessary. The hand or foot is then immobilized with bulky dressings or a cast.

The complextiy of the surgery depends on whether the condition involves just skin, or whether other soft tissues and bones are involved.

Indications
This surgery is advised for syndactyly in which functional ability or cosmetic appearance is impaired.

Risks
Risks for any anesthesia include the following:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery include the following:

     
  • Bleeding  
  • Infection

Other possible complications include the following:

     
  • Loss of skin grafts  
  • Circulation damage from the cast

Call your doctor if you notice the following:

     
  • Swelling  
  • Severe pain  
  • Fever  
  • Fingers that tingle, are numb, or have a bluish discoloration

Expectations after surgery
The repair is usually successful. When joined fingers share a single fingernail, the creation of two normal-looking nails is rarely possible. One nail will look more normal than the other. Some children require a second surgery, depending on the complexity of the syndactyly.

Convalescence

Hospital stays of one to two days are common.

Sometimes the cast extends beyond the fingers or toes to protect the repaired area from injury. Small children who have undergone webbed finger repair may need a cast that extends above the flexed elbow.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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