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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; Syndactyly release

Description

Surgery is done the following way:

  • General anesthesia will be given. This means the person is asleep and unable to feel pain. Or regional anesthesia (spinal and epidural) is given to numb the arm and hand.
  • The surgeon marks the areas of the skin that need repair.
  • The skin is cut into flaps, and the soft tissues are cut to separate the fingers or toes.
  • The flaps are sewn into position. If needed, skin taken (graft) from other areas of the body is used to cover places that are missing skin.
  • The hand or foot is then wrapped with a bulky bandage or cast so that it can’t move. This allows healing to take place.

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 anesthesia and surgery in general include:

  • Problems breathing
  • Reactions to medicines
  • Bleeding, blood clot, or 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
  • Injuries to the blood vessels, tendons, or bones in the fingers

Call your provider 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 to 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

Kay SP, McCombe DB, Kozin SH. Deformities of the hand and fingers. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 36.

Mauck BM, Jobe MT. Congenital anomalies of the hand. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 79.


Review Date: 9/22/2016
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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