• 1.

    McDaniel L, Tafuri SA: Congenital digital deformities. Clin Podiatr Med Surg 13: 327, 1996.

  • 2.

    Kozin SH: Syndactyly. J Am Soc Surg Hand 1: 1, 2001.

  • 3.

    Tian J, Wagner T, Hoevenaren I, et al: Progress in surgical strategies for treatment of simple congenital syndactyly: a systematic review. Eur J Plast Surg 41: 259, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Cronin TD: Syndactylism: results of zig-zag incision to prevent postoperative contractors. Plast Reconstr Surg 18: 460, 1956.

  • 5.

    Kajikawa A, Ueda K, Katsuragi Y, et al: Aesthetic repair for syndactyly of the toes using a plantar rectangular flap. Plast Reconstr Surg 126: 156, 2010.

  • 6.

    Park S, Eguchi T, Tokioka K, et al: Reconstruction of incomplete syndactyly of the toes using both dorsal and plantar flaps. Plast Reconstr Surg 98: 534, 1996.

  • 7.

    Marsh DJ, Floyd D: Toe syndactyly revisited. J Plast Reconstr Aesthet Surg 64: 535, 2011.

  • 8.

    Aizawa T, Togashi S, Haga Y, et al: Linear separation of toe syndactyly with preserved subcutaneous vascular network skin grafts. Ann Plast Surg 78: 311, 2017.

  • 9.

    Iida N, Watanabe A: The modified 3-square flap method for reconstruction of toe syndactyly. Plast Reconstr Surg Glob Open 4: e793, 2016.

  • 10.

    Tao X, Wang L, Gao W, et al: Effectiveness of dorsal pentagonal flap for reconstruction of the web space in congenital toe syndactyly [in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 29: 1117, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Matsumine H, Yoshinaga Y, Fujiwara O, et al: Improved “bell-bottom” flap surgical technique for syndactyly without skin graft. Plast Reconstr Surg 128: 504e, 2011.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hikosaka M, Ogata H, Nakajima T, et al: Advantages of open treatment for syndactyly of the foot: defining its indications. Scand J Plast Reconstr Surg Hand Surg 43: 148, 2009.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Mericli AF, Black JS, Morgan RF: Syndactyly web space reconstruction using the tapered M-to-V flap: a single-surgeon, 30-year experience. J Hand Surg 40: 1755, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Kawabata H, Ariga K, Shibata T, et al: Open treatment of syndactyly of the foot. Scand J Plast Reconstr Surg Hand Surg 37: 150, 2003.

  • 15.

    Lim YJ, Teoh LC, Lee EH: Reconstruction of syndactyly and polysyndactyly of the toes with a dorsal Pentagonal Island Flap: a technique that allows primary skin closure without the use of skin grafting. J Foot Ankle Surg 46: 86, 2007.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Itoh Y, Arai K: A new operation for syndactyly and polysyndactyly of the foot without skin grafts. Br J Plast Surg 48: 306, 1995.

  • 17.

    Langlais T, Rougereau G, Marty-Diloy T, et al: Surgical treatment in child’s congenital toe syndactyly: risk factor of recurrence, complication and poor clinical outcomes. Foot Ankle Surg 28: 107, 2022.

    • PubMed
    • Search Google Scholar
    • Export Citation

Patient-Reported Outcomes After Congenital Toe Syndactyly Repair with a Plantar Triangular Flap

Kaylee O’Connor Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX.

Search for other papers by Kaylee O’Connor in
Current site
Google Scholar
PubMed
Close
 BS
,
Sofia Gereta Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX.

Search for other papers by Sofia Gereta in
Current site
Google Scholar
PubMed
Close
 BA
,
Sarah A. Frommer Division of Plastic Surgery, Texas Children’s Hospital, Houston, TX.

Search for other papers by Sarah A. Frommer in
Current site
Google Scholar
PubMed
Close
 MD, PhD
, and
Steven L. Henry Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX.

Search for other papers by Steven L. Henry in
Current site
Google Scholar
PubMed
Close
 MD

Background: Syndactyly of the toes is a common congenital malformation, yet there are few reports of long-term outcomes after toe syndactyly repair and its effect on well-being. In this study, we surveyed patients and parents of patients who underwent toe syndactyly repair to investigate the functional and psychological outcomes of their surgery.

Methods: We reviewed the medical records of all of the patients who underwent toe syndactyly repair using a plantar flap technique between January 1, 2010, and January 1, 2021. Parents or patients completed a survey assessing their opinion regarding cosmesis, function, and overall satisfaction. Independent observers used a modified Vancouver Scar Scale to evaluate surgical scars.

Results: A plantar flap technique was used for 19 syndactylous webs in nine patients. Complications included one instance of mild cellulitis and one instance of web creep requiring revision. Average follow-up time was 5.5 years. Overall, 88% of survey respondents were very or moderately satisfied with the surgical outcome. No patients had unwanted hair growth or a bothersome groin site scar. Average modified Vancouver Scar Scale score was 3.2. There was a perceived improvement in toe range of motion and hygiene after surgery. Patients who underwent first web space release could wear flip-flops. All of the respondents would recommend surgery for another child with toe syndactyly.

Conclusions: Toe syndactyly repair can be performed with minimal complications and high parent/patient satisfaction. Survey results indicate that there may be functional and psychological benefits to undergoing toe syndactyly repair.

Corresponding author: Steven L. Henry, MD, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, 1501 Red River St, Austin, TX 78712. (E-mail: steven.henry@austin.utexas.edu)
Save