Patient-Reported Outcomes After Congenital Toe Syndactyly Repair with a Plantar Triangular Flap

Syndactyly of the toes is a common congenital malformation, yet there are few reports of long-term outcomes after toe syndactyly repair and its effect on well-being. In this study, we surveyed patients and parents of patients who underwent toe syndactyly repair to investigate the functional and psychological outcomes of their surgery.

We reviewed the medical records of all of the patients who underwent toe syndactyly repair using a plantar flap technique between January 1, 2010, and January 1, 2021. Parents or patients completed a survey assessing their opinion regarding cosmesis, function, and overall satisfaction. Independent observers used a modified Vancouver Scar Scale to evaluate surgical scars.

A plantar flap technique was used for 19 syndactylous webs in nine patients. Complications included one instance of mild cellulitis and one instance of web creep requiring revision. Average follow-up time was 5.5 years. Overall, 88% of survey respondents were very or moderately satisfied with the surgical outcome. No patients had unwanted hair growth or a bothersome groin site scar. Average modified Vancouver Scar Scale score was 3.2. There was a perceived improvement in toe range of motion and hygiene after surgery. Patients who underwent first web space release could wear flip-flops. All of the respondents would recommend surgery for another child with toe syndactyly.

Toe syndactyly repair can be performed with minimal complications and high parent/patient satisfaction. Survey results indicate that there may be functional and psychological benefits to undergoing toe syndactyly repair.