It’s great if the baby was born healthy! But sometimes his parents are surprised to find strange defects in him. Take, for example, the fused toes of the newborn. Sometimes they can explain the reasons for this pathology by the fact that in their family the named special sign is passed on from generation to generation, but sometimes it is quite difficult to understand what triggered the development of the defect. What constitutes syndactyly (intergrowth of the fingers of the upper or lower extremities), and why it develops, we will talk in our article.
Syndactyly is not common
The child’s fused fingers and toes are fixed quite rarely - in one case, for 2-3 thousand newborns. Moreover, in girls this is 2 times less common than in boys. Most often, 2 and 3 toes or middle and ring fingers on the hand turn out to be fused. Most often, such a fusion does not affect joints and tendons, making the problem only cosmetic.
And if the fingers on the hands, as a rule, are subjected to surgical separation, then the legs are often not touched, not seeing in the defect a special obstacle to the development of the child (such a violation usually does not interfere with normal walking). True, in the presence of syndactyly in 60% of such children, another congenital pathology of the limbs is most often detected - deformity of the feet, pseudoarthrosis, clubfoot, etc.
Fused toes in a newborn: causes of pathology
What triggers the appearance of syndactyly? The fact is that the fingers and toes of the baby are laid at 4-5 weeks of pregnancy, when the mother usually still does not suspect about her, and therefore does not limit herself to anything. Hence, there is a high probability that harmful factors can influence the fetus - x-ray radiation, taking antibiotics, alcohol, smoking, etc. The danger of serious consequences for the pregnant woman and her fetus from diseases such as flu, mumps, or syphilis cannot be ruled out.
And the most common reasons that the toe is fused together in the newborn is heredity, which is transmitted from parents to children.
By the way, if a child is found to have syndactyly even to a mild degree, he must be examined for the presence of gene and chromosomal syndromes ( Apert, Poland or Edwards syndrome ), in which finger fusion is one of the symptoms of serious defects in the development of the baby.
By the way, in medical practice, cases of acquired finger fusion as a result of a chemical or thermal burn of a hand or foot were also observed.
What to do if the baby has joined fingers and toes, we will talk further, but for now a little theory.
How is pathology classified?
In medicine, the pathology we are considering is classified according to the condition of the bones and the degree of fusion. So, by the appearance of adhesions, syndactyly is soft tissue and bone, and by the magnitude of fusion, it is complete and incomplete.
Depending on how exactly the fingers on the foot or arm join together, syndactyly happens:
- skin membranous - between the fingers there is a membrane of skin (this type of pathology is considered the easiest);
- cutaneous - between the fingers there is dense skin with underlying soft tissues, most often along the entire length of the fingers;
- bone - fusion occurs at the level of the phalanges, and they are usually underdeveloped or deformed;
- compatible - there are several types of syndactyly (this form is considered the most difficult to treat).
Diagnosis of syndactyly
As a rule, syndactyly is detected already in the first hours of a newborn’s life, upon examination by a neonatologist. If the baby's toes are fused, then the question of the need for surgery, as a rule, is not acute, and parents have the opportunity to weigh the pros and cons of surgical intervention.
In order to have a complete picture of the pathology, the baby should be shown to a pediatric surgeon and an X-ray of the foot in two projections. This will determine the features of the defect and the condition of the bones and joints of the baby.
How is syndactyly treated
And yet, regardless of why the toes join together, surgery is the only treatment for this pathology.
The optimal age of the baby for this is 4-5 years. True, in the event that the terminal phalanges of the fingers are connected , it is better to carry out the operation before the age of one year in order to prevent uneven growth of the fingers and their deformation.
Surgery to eliminate syndactyly is divided into 5 groups:
- Simple dissection with membranous fusion.
- Cutting using skin grafting with local tissues.
- Cutting using skin grafting using a full-layer or split skin flap.
- Dissection using combined skin grafting (free autografts or local tissues are used).
- The operation in several stages, including bone, tendon-muscle and skin grafting.
Which of the following operations will be the most optimal, the doctor will decide, taking into account the nature and form of the pathology.
Postoperative period: how much does the toe grow together?
After the operation, the recovery period, as a rule, takes place at home. Limbs at this time need rest (for a month). It is necessary to follow all the instructions of the doctor, providing proper care for postoperative wounds.
They, to reduce the inflammatory process and get rid of scars, are lubricated with Dermazin ointment or Kontraktubeks gel, and after about 7 weeks, as prescribed by a specialist, they begin to attend physiotherapeutic procedures. By the way, do not rush into this - let the postoperative wounds heal properly so as not to hurt the child during new procedures.
In some cases, the wearing of spacers from the turbocast is also prescribed so that the seams do not heal on the operated fingers. At first (within a month) they are worn constantly, and then put on only for sleep.
It should be noted that if all the requirements are followed, you will soon forget about the problem we are considering (the child has joined fingers toes). The patient will recover quite quickly and without complications.
Forecast
Despite the fact that cases of syndactyly have become more frequent in our time, to which researchers have not yet found sufficient explanations, the prognosis of the course of this pathology is mostly favorable. Modern treatment methods can get rid of the defect, restoring all the functions of the hand or foot and correcting the deformation of the fingers.
If the baby's fingers or toes join together, the operation allows the formation of normal interdigital spaces and at the same time maintain joint mobility and sensitivity of the patient’s fingers. That is, to relieve him of any difficulties associated with syndactyly.
Is it necessary to have surgery for toe syndactyly
Almost always, parents, having discovered finger problems in their baby, begin to insist on immediate surgery. But if the fused fingers can indeed cause not only aesthetic, but also physical problems, then in a situation where there is a defect in the legs, especially if the fingers are not deformed and bend normally, you can do without surgery.
If a woman’s toes that have grown together can cause a lot of negative emotions, up to the reluctance to wear open shoes or walk barefoot on the beach, then the child, as a rule, does not have such a problem and will not, naturally, with the right attitude towards her. Many people live without experiencing any unpleasant sensations from the fingers that have grown together on their feet. And for some, this special sign also becomes a kind of highlight. As you can see, it all depends on whether you accept yourself as you are.