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Repair of webbed fingers or toes
Definition
Repair of webbed fingers or toes is surgery to fix webbing of the toes, fingers, or both. The middle and ring fingers or the second and third toes are most often affected.
Alternative Names
Web finger repair; Web toe repair; Syndactyly repair
Description
This procedure is done using general anesthesia. The patient is asleep and pain-free.
The health care provider will mark the areas of skin that need repair.
The surgeon cuts the skin, then lifts up small flaps in the web and at the sides of the fingers or toes. The flaps are sewn into position, leaving missing areas of skin. These areas may be filled in with skin taken from the groin area, if necessary. The hand or foot is then wrapped with a bulky bandage or cast so that it cannot move.
Simple webbing of fingers or toes involves only the skin and other soft tissues. The surgery is more complicated when it involves fused bones, nerves, blood vessels, and tendons.
Why the Procedure Is Performed
This surgery is advised if the webbing causes problems with appearance, or in using the fingers or toes. Generally, the repairs are done when a child is between 6 months and 2 years old.
Risks
Risks for any anesthesia include the following:
- Problems breathing
- Reactions to medications
Risks for any surgery include the following:
- Bleeding
- Infection
Other possible complications related to this surgery include the following:
- Damage from not getting enough blood in the hand or foot, due to the cast
- Loss of skin grafts
- Stiffness of the fingers or toes
Call your doctor if you notice the following:
- Fever
- Fingers that tingle, are numb, or have a bluish tinge
- Severe pain
- Swelling
After the Procedure
Most people stay in the hospital for 1 - 2 days.
Sometimes the cast extends beyond the fingers or toes to protect the repaired area from injury. Small children who had webbed finger repair may need a cast that reaches above the elbow.
Outlook (Prognosis)
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 if the webbing is complicated.
The separated fingers will never look or function the same.
References
Jobe MT. Congenital anomalies of the hand. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 76.
Vidyadharan R, Lester R. Syndactyly correction: an aesthetic reconstruction. "The Journal of hand surgery, European volume." J Hand Surg Eur Vol. 2010 Jul;35(6):446-50.
Carrigan RB. The upper limb. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 673.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
