Syndactyly is a condition which causes webbed toes or fingers and is characterized by the fusion of 2 or more toes or fingers.
It can occur alone or as part of a genetic syndrome.
Although syndactyly does not impair one’s ability to run, jump, walk, or swim, there are some disadvantages.
In the US, it is one of the most frequent birth abnormalities, affecting about 1 in every 2,000 to 3,000 children born every year.
Worldwide, the incidence is around 1 in 2000 live births. Caucasians and boys are more likely to be affected.
The condition most frequently affects the 2nd and 3rd toes, however, it can occur between any of the toes. It affects both hands about 50% of the time.
It is classified in the following ways:
- complicated – the fingers are joined by soft tissue as well as bony or bone cartilage, in a fashion other than side-by-side;
- complex – by soft tissue as well as bony or bone cartilage, in a side-by-side fashion;
- simple – adjacent toes or fingers are joined by soft tissue and skin only;
- complete – when the entire length of the digits are joined together by skin;
- incomplete – a soft tissue that does not run the complete length of the toes.
The main symptom of the condition is webbed toes or fingers. Also, suferrers may notice that the affected toes or fingers do not move correctly.
If left untreated, syndactyly can impair hand dexterity and function dexterity and finger growth. Also, it can have a negative effect on a person’s self-esteem.
During the process of fetal development, the fingers and toes are all fully webbed at first.
Around 6 to 8 weeks, apoptosis takes place, meaning that an enzyme dissolves the tissue between the digits, leading to the disappearing of the webbing and creates fully separated fingers and toes.
In some people, this process doesn’t fully happen, and parts of the webbing are still left behind.
The cause of webbed toes is not entirely known, although it may be congenital (inherited – anyone with the gene has a 10 to 40% chance of passing on the gene which causes syndactyly) or it may be associated with other conditions, such as:
- Edwards syndrome;
- Aarskog–Scott syndrome;
- Pfeiffer syndrome (characterized by the premature fusion of certain skull bones);
- Acrocallosal syndrome;
- Timothy syndrome;
- Apert’s syndrome (characterized by the premature fusion of certain skull bones);
- Klippel-Feil syndrome;
- Bardet-Biedl syndrome;
- Ectodermal dysplasia;
- Carpenter syndrome;
- Smith-Lemli-Opitz syndrome;
- Cornelia de Lange syndrome;
- Miller syndrome (characterized by distinctive craniofacial malformations);
- Fetal hydantoin syndrome;
- Jackson–Weiss syndrome.
According to the January 2016 issue of Plastic and Reconstructive Surgery, smoking cigarettes during pregnancy notably increased the risk of having a child with webbed, excess, or missing toes and fingers.
Furthermore, according to this study, smoking just 10 cigarettes a day increases the risk of having a child born with a finger or toe defect by 29%.
The condition can be diagnosed before birth during an ultrasound, however, it is typically identified after birth.
If your child is born with syndactyly, the healthcare professional will check for signs and symptoms of a more complex condition.
Also, an x-ray is used to see if the baby’s soft tissues or bones are joining.
The condition usually does not cause physical disabilities. But, surgery is occasionally performed to remove the excess skin.
If the condition affects the foot, the nr.1 reason for surgical intervention is cosmetic disapproval by the sufferer, rather than loss of mobility.
Also, when joined fingers share a single fingernail, the creation of 2 normal-looking nails is a bit hard.
The surgery is commonly performed at 6 to 24 months.
The general method for addressing syndactyly is creating zigzag cuts along the webbing. After, the surgeon will attach the flaps of skin created by the cuts to the fingers. Also, general anesthesia will be given.
The procedure can last from 2 to 4 hours. Additionally, you may stay in the hospital for 1 or 2 days after surgery.
The patient will need to wear a cast on his feet or hands for approximately 21 days. Also, about 14 days after surgery, the patient will be examined by the surgeon.
Physical therapy helps after surgery to prevent tissue shortening and scarring.
Risks of Surgery
As with all medical surgeries, there is a risk of necrosis (the death of most or all of the cells in an organ or tissue) or bleeding infection of the smaller skin flaps raised during surgery.
Other possible complications related to this surgery may include:
- injuries to the tendons (a fibrous connective tissue), blood vessels, or bones in the fingers;
- stiffness of the toes or fingers;
- loss of skin grafts;
- damage from not getting enough blood in the foot or hand.
The overall prognosis for the condition is quite good and most of the affected individuals have normal function of the feet and hands when they grow up.
Toes symbolize certain details about the future. They provide balance and help to perceive the soil, in other words, the world in general.
Due to the fact that the toes are the part of the body that moves forward, webbed toes indicate a great confusion about the direction that one follows and the lack of freedom and inner clarity, which makes one want to run.
It also indicates stress and rejection of the idea of moving forward.