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THE UK'S FIRST AND MOST EXPERIENCED DEDICATED COSMETIC FOOT SURGERY CENTRE

Toe Splitting Surgery (De-syndactyly)

This lady returned and has now had both her 2nd-3rd toes separated surgically.

"I cannot express enough how delighted I am with my "splitting joined toes" surgery from my initial encounter with the foot & ankle clinic at Harley street, I was very well informed of the procedures from start to finish with superb communication exchange by the team at Harley street.

Now, I can't find words to explain how Mr Jason Hargrave is the most amazing, talented surgeon I have ever met. See you'd expect someone his calibre to be arrogant & out of touch with his patients, far from the truth. Jason can do this operation with his eyes closed, that's how good he is. I think he was more excited than I was after the surgery. Jason takes more reward from the patient's satisfaction than his own work. Lovely man & simply the best.

I can't thank Jackie Morley enough for her amazing professionalism & care. She is very committed to make patients feel at ease with fantastic knowledge of the procedures. Truly amazing service!! I believe she should be a surgeon herself without a doubt. It's rare to come across a warm, friendly, attentive service theses days!

I will be doing my next foot very very soon & I will never consider anyone else to do it.

Mrs MS – Watford"

Webbed-Toes (syndactyly):

Webbed or webbing of the toes (medical term – syndactyly) is when two or more toes are fused together. Polysyndactyly describes webbing of multiple fingers or toes. Webbed toes are also known as "twin toes," "duck toes," and "tiger toes." The condition in humans is purely cosmetic. Syndactyly itself does not impair the ability to perform any physical activities such as walking, running, or swimming.

Psychological stress may arise from the fear of negative reactions to this condition from people who do not have webbed toes. This includes the fear of embarrassment to show feet in a situation where the feet are normally uncovered, such as on holiday or when swimming etc.

The amount the toes are joined does vary from simple partially joined to the more complex complete syndactyly. In most cases this is just the skin (simple syndactyly) but occasionally the bones can also be fused together (complex syndactyly), which would require an x-ray. In most cases the exact cause of digital syndactyly is unknown. However, there are some medical conditions that can cause it:

More common medical causes include: Down syndrome and Hereditary syndactyly

Very rare causes include: Apert syndrome; Carpenter syndrome; Cornelia de Lange syndrome; Pfeiffer syndrome and Smith-Lemli-Opitz syndrome. Use of the medication hydantoin during pregnancy (foetal hydantoin effect) may cause syndactyly.

So far in our practice we have only seen the presentation as either a congenital (birth) defect with no underlying medical reason or a hereditary syndactyly. There are also various levels of webbing, from partial to complete. We do know that syndactyly is the result is incomplete separation of the toes in the uterus. It can affect any of the toes but the vast majority are the 2nd and 3rd toes. One or both feet may be involved although for 2-3 syndactyly, it is usually on both sides.

The Surgery

The decision whether or not to proceed with surgery is generally a cosmetic one but we understand the psychological embarrassment that these types of toe deformities can cause. The surgery itself can be undertaken painlessly under a local anaesthetic nerve block, which can be combined with sedation, or under a full general anaesthetic, depending on your preference. Usually you will be allowed home on the same day. Some of the risks involved are wound breakdown or slow healing, unsightly scarring (including scar contracture), infection, circulatory and or nerve damage (reduced with skin graft procedure). Less common risks include DVT

– deep vein thrombosis or vein clot (~0.33% risk), and pain and sensitivity persisting and requiring specialist pain treatment. We are obliged to say that loss of a toe or toes is a possibility of the surgery although to date this has not happened for this procedure in our practice and vascular damage is minimised using our technique.

Following surgery you will be required not to weight-bear for the first 3-weeks after surgery to reduce swelling, wound irritation and failure of the skin graft that could adversely affect healing and the final result.

The cases demonstrated above are all patients from our practice. A small amount of partial syndactyly can sometime be separated by a simple split and suture technique. Where the toes are more significantly webbed, the use of skin graft from below the ankle on the outside of the foot is necessary. This technique is less risky to the toe’s circulation but a scar underneath the outside of the ankle is inevitable where the graft is taken from. Scars do heal over time, even up to 2-years and we can advise you on scar-care and where to obtain scar reduction products from.

Skin grafting certainly produces more scarring at the donor site but not where the toes are and the results are very pleasing for patients who are usually very embarrassed to show their feet and frequently report to us that they "hate" their feet.

This is a quote from one of our patients who underwent surgery to separate three pairs of webbed toes:

“I followed the Post-Op care instructions to the letter and I can only say that I am honestly astounded at the recovery and the results. I am absolutely thrilled and have booked for my other foot to be done in the coming months…. The psychological and emotional burden this condition brings with it have disappeared and I am grinning from ear to ear at the anticipation of wearing flip-flops for the first time in nearly 40 years! M.G. London”

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Call us: +44 (0)207 870 1076  Email us: jackie@foot-surgery.co.uk