Syndactyly of the foot refers to a congenital developmental abnormality that is characterised by limb malformation such as unilateral or bilateral webbed toes. It can be either partial or complete, and symmetrical or asymmetrical.
This deformity can occur independently or as part of an extremely varied group of syndromes such as Peters syndrome, caudal regression syndrome, Rubinstein-Taybi syndrome and Ellis-Van Creveld syndrome.
As mentioned by Edwin Harris, from the Department of Orthopaedics and Rehabilitation at the Loyola Medical Centre, complete syndactyly involves fusion that extends to the hyponychium while incomplete syndactyly is defined as partial fusion of adjacent soft tissue segments of the toes.
Among the two types of syndactyly outlined, the author describes central syndactyly as the most common form which entails a complete fusion of the second and third toes; the distal portion of the second toe is observed to be abducted due to the wedging of the middle phalanx with the apex lateral.
Kim et al. conducted a large-scale study to better understand the clinical features of isolated foot syndactyly by reviewing 118 patients who underwent surgical correction for the condition over a span of 25 years.
The authors observed that the second web was the most frequently involved in unilateral cases followed by the fourth, the first, the third, the first and second in combination, and the second and third in combination.
At the end of the study, the authors concluded that foot syndactyly surgery using a dorsal skin flap and a sufficient full-thickness skin graft may be necessary for better postoperative outcomes and to lower the rate of complication.
MASS4D® customised foot orthotics are often included in post-surgical rehabilitative programmes for patients over the age of 10 years old to provide support to the feet. This would help in positioning the foot in its optimal posture, enforcing normal functioning and movement.
MASS4D® also helps in properly aligning the toes so as to facilitate an even distribution of pressure in the plantar surface of the feet and to avoid ‘hotspots’ that could create long-term complications for the individual following surgical success.
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Repetitive plantarflexion can lead to pain and mechanical limitation in the posterior ankle joint which is known as posterior ankle impingement syndrome. This pathology commonly occurs in ballet dancers and football players.