Why do some newborn children have fused toes? What does such a pathology mean, and is it possible to get rid of it? You will find answers to these and other questions regarding the aforementioned deviation from the materials in this article.
General pathology information
Fused toes are a congenital malformation of the lower extremities. Such a deviation is characterized by incomplete or complete fusion of two or more fingers. In medical practice, fused toes have a special name - syndactyly.
With such a pathology, a person may experience a fusion of both deformed and underdeveloped fingers, and correctly developed. The result of syndactyly is a functional and cosmetic defect in the lower limb.
A child with such a deviation should definitely be consulted by a geneticist and orthopedic surgeon. To establish the type of syndactyly, an X-ray of the foot should be performed. The treatment of this defect is carried out only by surgery. In this case, two fused toes are separated, and in case of acute need, plastic closure of the defect is also used.
Some statistics
Syndactyly is the abnormal development of the fingers, which is the result of a violation of their correct separation. As a rule, this occurs in the embryonic period.
Fused toes in a newborn baby are found with a frequency of 1 to 3000. It should be noted that syndactyly is about half of all congenital anomalies. Such a pathology of the foot can be either an independent deviation or be combined with other defects (for example, finger hypoplasia, polydactyly and polyphalangia, ectrodactyly, brachydactyly, brachioradial synostosis, splitting of the hand, ulnar or radial obliquity, etc.).
About 60% of children who have fused toes (photo of the defect presented in this article) have congenital abnormalities in the musculoskeletal system (for example, pseudarthrosis, clubfoot, pathological installation of the feet, etc.).
Reasons for the defect
Why do children develop such a defect as fused toes? The reasons for the appearance of this deviation may be different. Experts believe that in 20% of cases this is due to a hereditary factor. In other words, the autosomal dominant type of inheritance is to blame.
If syndactyly is absent in the family history, then it should be assumed that violations of differentiation and formation of the lower extremities of the fetus occurred during embryogenesis. This usually happens if there is exposure to various adverse factors.
How does a defect develop?
Why are my toes fused to my feet, and how to explain this development of limbs? The laying of the foot of the unborn child occurs at the 5th week of intrauterine formation. It is at this time that the fetus can develop physiological syndactyly.
In the absence of a defect, fingers are already formed at the 7th week. This is due to the growth of finger rays and a slowdown in the development of interdigital spaces. If the reduction of the interdigital septum is impaired, then the phalanges are not disconnected, that is, syndactyly occurs.
Possible causes of pathological development
Fused toes in the child can be observed with toxic effects on the body of a pregnant woman. In most cases, this occurs during the administration of medicines, alcoholic beverages, as well as in adverse environmental conditions, occupational characteristics, x-rays and infectious diseases (e.g., flu, syphilis, tuberculosis, etc.).
Often, the causes of the birth of a baby with syndactyly remain unclear.
Fused toes are a frequently observed defect that is part of the structure of chromosomal and gene syndromes.
By the way, it is very rare for people to have acquired syndactyly. As a rule, such a pathology occurs after burns of the foot (chemical or thermal).
Fused toes - what does this pathology mean?
Many people who are actively keen on mysticism believe that such a pathology develops for a reason. It is believed that this type of mutation is diabolical. And indeed, the fused fingers are pretty much like a hoof.
However, doctors claim that there is nothing strange and terrible in such a development of the foot. This is just an anomaly of the limb, which is quite easy to get rid of, especially in the early stages of a child’s life.
Therefore, do not worry too much if you have fused toes. What this means, only a doctor can tell you, and not lovers of devilish marks.
Defect classification
In orthopedics, syndactyly is classified taking into account the length, type of fusion, as well as the condition of the fingers.
Currently distinguish:
- bone form (if bone adhesion occurs);
- soft-tissue form (sometimes webbed and skin).
The classification of a defect in extent depends on the number of fused phalanges and the length of the fusion.
As for the condition of the fused fingers, syndactyly can be complex and simple. In the latter case, normal fingers merge, and in the former, with abnormalities of the bone, articular, tendon, or ligamentous apparatus.
Genetic types
Syndactyly is also classified by genetic types:
- The first type is zygodactyly. Partial or complete fusion (membranous) of the 2nd and 3rd toes. Also, membranes between other fingers are not excluded.
- The second type is synpolidactyly. Fusion of the 4th and 5th toes with a doubling of the 5th. Such a pathology is characterized by: disturbances in the surface of the skin of the soles and hypoplasia of the middle phalanges.
- The third type. Bilateral full syndactyly of the 4th and 5th fingers of the hand. In this case, the feet are not affected.
- The fourth type is Gaza syndactyly. Complete bilateral skin brush syndactyly. In this case, foot damage is absent.
- Fifth type. The fusion of the metatarsal and metacarpal bones. On the hands, the fusion of 3-4 fingers is more common, and on the feet - 2 and 3.
Defect symptoms
With syndactyly on the feet of a child, the fusion of the 2nd and 3rd fingers is most often observed. At the same time, the undivided phalanges can either be underdeveloped or normally developed. In some cases, there is a decrease in the number of fingers due to their amniotic amputation.
Unlike children with syndactyly on their hands, children with syndactyly on their feet develop quite normally. They have no problem performing a wide range of activities. At the same time, the functional inferiority of the foot does not make learning difficult, and also almost never limits the choice of a future profession.
How is it diagnosed?
How are the toes connected to the foot diagnosed (a sign of which such a defect has been described just above)? Syndactyly is detected by a neonatologist immediately after the birth of the baby. Further observation of the child is carried out by a pediatric orthopedist or surgeon. To exclude chromosomal and gene abnormalities, a geneticist can also be connected.
Despite the fact that such a diagnosis is established after a visual examination to clarify the type of defect, as well as the development of therapeutic tactics, an instrumental study should be carried out.
X-ray of the feet in two projections allows specialists to evaluate the density of bone tissue, the condition of the joints, the length and presence of bone fusion. To identify the features of blood circulation and the vascular network in the fingers, an ultrasound scan, rheovasography, angiography and electrothermometry are done.
Pathology treatment
Can fused toes be cured? The operation to separate the phalanges is the only possible solution. However, it should be noted that surgical intervention is used only for syndactyly of the fingers. As for the fused phalanx of the feet, then in this case the operation is not shown. If such a pathology interferes with normal walking, then the intervention is still carried out.
When does the operation take place?
The timing and method of surgical intervention are determined taking into account the nature and form of the defect. The purpose of this treatment is to eliminate cosmetic defects, as well as improving the function of the foot or hand.
The optimal period for the operation is the age of 4-5 years. If the newborn baby has end syndactyly, then the intervention is carried out in the second half of his life. This helps prevent secondary deformation of the fingers and uneven growth of the phalanges.
Surgical approaches
During surgery, the following surgical approaches can be used:
- separation of fused fingers with skin plastic with local tissues;
- separation of membranous fusion without skin grafting;
- separation of fused fingers, which is complemented by combined skin grafting using free autografts and local tissues;
- separation of fused fingers, which is complemented by free skin grafting with a full - layer or split skin graft;
- multi-stage interventions with tendon-muscle, skin and bone plastics.
Postoperative period
After surgery, a removable plaster cast is applied to the limb to immobilize the divided fingers. It is recommended to wear it for at least 3-4 months.
About 15 days after surgery, the patient is restored. To do this, use massage of the hands or feet, exercise therapy, phonophoresis with lidase, electrical stimulation of the muscles of the fingers, ozocerite, paraffin and mud applications.
The result of the operation
The methods of treatment of syndactyly used in modern surgery give good cosmetic and functional results. With timely intervention, not only the normal structure is fully restored, but also the functions of the hand and foot.
The operation to eliminate syndactyly was successful if the patient has no constricting scars and lateral deformity of the fingers, as well as a full range of movements in the interphalangeal joints (adduction, abduction, extension and flexion), grasping function (in the case of the hand), good sensitivity and natural form spaces between fingers.
If it is decided not to carry out the treatment of syndactyly, then this can have a negative impact on the development and growth of the baby's limb.