Webbed toes are a common occurrence in the animal kingdom—ducks, for example, use them to power through the water. What you may not know is that human fetuses also start out with webbed toes. Toe separation doesn’t normally occur until about the sixth to eighth week of pregnancy, when a certain enzyme dissolves the extra tissue between the toes.
However, in about one out of every 2,000 births, this process of toe separation is never fully completed. The infant is born with at least two toes that are at least partially connected. The underlying cause for this condition, medically known as syndactyly, is not fully understood, although it is known to run in families, and is more common in children born with down’s syndrome, along with a handful of other, rarer genetic syndromes.
Types of Webbed Toes / Syndactyly
Webbing between toes can occur in either or both feet. The most common variation of the disorder shows up between the second and third toes, and involves only skin or other soft, flexible tissues. However, any two (or more) toes may be affected, and multiple types are possible:
- Incomplete vs. Complete: Incomplete webbing only goes partway up the toes, while complete webbing extends all the way up the digits.
- Simple: Only soft and flexible tissue (i.e., skin) is involved in the connection.
- Complex: Some harder tissues (i.e., bone and/or cartilage) are fused, in addition to skin.
- Complicated: Not only is the fusion complex, but it is also joined in an irregular way (for example, some bones are out of alignment or missing).
Does My Child Need Treatment or Surgery for Webbed Toes?
It depends on the situation. Many simple webbed toes do not cause significant symptoms or hardship other than being a cosmetic irregularity. Often they have no effect on a child’s natural development or ability to walk, run, swim, or play sports. In such cases, you may decide to wait until your child is a little older and let them make the decision.
However, more severe webbed toes may impair foot function down the road. Furthermore, they can be a source of embarrassment for your little one. If we feel that the benefits of separating the digits outweigh the surgical risks, we may discuss that as treatment option with your family.
(To be clear, surgical complications are rare, but even a very small potential for problems might not be considered worth it if your child is not experiencing any physical impairment from the condition.)
Surgery for Webbed Toes
Surgery is the only possible treatment for webbed toes. Typically we’d recommend that the child reach at least few months of age before attempting any toe separation procedure, and we’ve performed surgery on older children and even adults many times. That said, if we believe the webbed toes are likely to impair your child’s foot function, it’s best to address the condition before developmental milestones (like learning to walk).
Simple webbed toes (just skin involved) tend to be relatively simple procedures; the surgeon will cut the webbing in a zigzag pattern, then stitch the excess skin to the now-separated toes. If bones or tendons are involved in the fusion, surgery is more complicated but still highly successful on average. In either case, skin from another area of the body (such as under the arms) may need to be grafted onto the toes. In order to reduce the risk of complications, we typically would only separate two toes at a time during a single procedure.
Recovery typically lasts a few weeks to a few months. Your child will need a cast at first to protect the toes while they heal, afterward, additional measures (such as braces, rubber toe spacers, and physical therapy) may be employed temporarily. There is a minor risk of recurrence, but in the vast majority of cases the child’s toes will grow and develop normally, with full articulation and function.
From webbed toes and extra digits to clubfoot, intoeing, and more, the Southern California Foot & Ankle Specialists are Orange County’s foremost experts on surgical correction and non-surgical treatment for childhood foot deformities. If you’re concerned about your little one’s feet, please give our Ladera Ranch office a call at (949) 364-9255.