Webbed Toes

Webbed toes are among the most common anatomical differences seen in newborns. The medical term for webbed digits is “syndactyly.” The cause may be genetic, inherited, or unknown.

Webbed toes may not affect function or activity level, but surgery can correct them if the condition restricts activity or causes discomfort. They can also be corrected for cosmetic reasons.

This article will explore webbed toes and what can be done to address them.

What Causes Webbed Toes?

When a fetus is developing in the uterus, its fingers and toes are fused until about six to eight weeks of gestation. The tissue connecting them then begins to die off, so the digits separate in most cases. However, in some fetuses, tissue remains, which results in webbed toes or fingers.

Webbed toes can be caused by a congenital condition, meaning something happens during fetal development, or the cause may be unknown.

Up to 40% of babies born with syndactyly have a genetic condition that causes it. These conditions can be caused by a genetic change that first occurs in the affected person (de novo) or by a genetic variation inherited from a parent.

Some of these genetic changes don’t appear to have effects other than webbed digits. In other cases, webbed digits may appear in genetic conditions that have many other effects.

Webbed digits can result from Apert syndrome, a rare genetic anomaly that affects the bones. The condition generally is due to a mutation (genetic change) occurring in the fetus rather than being inherited from a parent. But a person with Apert syndrome may then pass the condition to their offspring.

Bardet-Biedl syndrome is an inherited condition that typically affects eyesight but is also associated with syndactyly. About 9% of children with Down syndrome (a chromosomal condition) also have webbed toes.

In some ancient and modern cultures, webbed toes have spiritual associations. They may be considered a sign of good luck, divinity, or a special connection to the natural world. In folklore, webbed toes are seen as protection from evil spirits or as a magical ability to heal or cast spells.

Types of Webbed Toes

Over the years, researchers have categorized webbed toes in several different ways, depending on which toes are involved, what tissues are fused, and even genetic characteristics. The basic categories, by type and extent of the fused toes, include.

• Simple syndactyly: Webbing is formed by skin and soft tissues such as tendons and ligaments.
• Complex syndactyly: Some bones are connected, and some or all of the toes may be affected.
• Complicated syndactyly: Additional bone tissue forms, and there may also be abnormal tendons or ligaments.

Webbing of the skin between the second and third toe, called zygodactyly, is the most common form of fusion. The second most common form is webbed skin between the fourth and fifth toe.

Do Webbed Toes Need Correcting?

Children with webbed toes may not need treatment if the webbing is not affecting their mobility. However, in some cases, webbed toes can affect function and balance, and surgery can usually correct them.

Surgery is also an option if a person has concerns about the appearance of the foot. There is no other treatment for webbed toes.

Surgery for Webbed Toes

If surgery is the chosen treatment for a child, it is usually done when a child is between 1 and 2 years old. This reduces the chance of developing a malformed joint and lowers anesthesia risks, which are higher in younger children.

The surgery can also be done in adults, but it can be more complicated and take longer to recover.

The surgical approach varies depending on the complexity of the fusion. If only skin and soft tissue are connected, the surgeon can simply split the skin, sometimes in a “Z” shape. They may use a skin graft from another part of the body to cover the wound completely.

If more than two toes are involved, the provider may recommend a series of surgeries rather than addressing all the fusions at once.

Occasionally, scar tissue grows between the toes, a condition called “web creep.” A second surgery can correct this issue. Web creep is more likely in children who have the surgery before they turn 1.

After the operation, a healthcare provider will put a cast over the foot. In a few weeks, the cast will be removed and replaced with a brace until the foot has healed. If needed, physical therapy can aid in recovery.

Living With Webbed Toes

If you decide not to correct webbed toes, perhaps because the webbing is minimal, there are a few considerations to take into account:

• Choose footwear with care, avoiding shoes that put pressure on the fused areas.
• Children may feel embarrassed or self-conscious about their toes in situations where people tend to go barefoot. Work with your child to ensure that you address any social discomfort.

Summary

Webbed toes and fingers are among the most common anatomical differences in newborns. The causes may be unknown or genetic. Some genetic causes can be inherited. Surgery can correct the fusion, and the operation is usually done on children when they are between 1 and 2 years of age.

In minor cases, in which only the skin is fused, surgery may not be necessary except for cosmetic reasons. The surgery can be relatively simple or more complex, depending on the nature of the webbing, which can involve skin, skin and other soft tissue, or sometimes bones, ligaments, and tendons.