Webbing between toes shouldn't affect foot
Examining newborns and congratulating tired, but ecstatic new parents is not a bad way to start a workday. I began morning rounds by checking all my new babies in the hospital nursery, and then moved on to visit the mothers in their private rooms. I let the mom of a particularly cute newborn know that her baby looked great, with a perfectly normal-sounding heart and a healthy set of lungs.
We finished our conversation and I walked out of the room, heading for my next patient, when I paused and went back into the room. I remembered that I hadn't mentioned a little exam finding that didn't concern me, but which might worry the parents. “There's one more thing you should know,” I told the mother. “You'll find that your baby has a little extra webbing between the second and third toes on each foot.”
I was going to reassure the young mother about the benign nature of this webbing, but it turned out that she was unfazed by my news. “I saw that,” she explained, “and I already called home to let my husband know. He has toes just like our son!” It's always nice to leave parents comfortable and happy with their new baby, from head to toe.
Toe webbing can vary from partial to complete fusion of the skin between two adjacent toes, and while it can be surgically corrected for cosmetic reasons, webbing generally does not affect the actual function of the foot. In fact, if I feel I can joke around with the baby's parents and this isn't always the case I'll tell them that webbed toes will probably make their child a better swimmer. (I haven't seen any real medical studies on this one, so don't quote me.)
Syndactyly is the scientific term for this webbing of the fingers or toes. Syndactyly of the digits can be associated with other abnormal anatomic features as part of a syndrome, or can be an isolated finding, of not much medical significance.
Researcher Sajid Malik and colleagues in the European Journal of Human Genetics explain that the most common type of “nonsyndromic” syndactylies is Type I syndactyly, an inherited condition. Type I syndactyly is found in 3 out of 10,000 newborns and involves webbing of the fingers and/or toes. Type I is further broken down into syndactyly subtypes, with the mildest and the most frequently encountered version subtype I resulting in simple webbing of the second and third toes without any finger involvement.
The webbing found in syndactyly subtype I varies from very minimal webbing of the second and third toes on one foot to complete webbing of the second and third toes on both feet. While even toenails can be fused in this condition, the bones of the toes are never involved in this most common form of syndactyly.
Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.