28345 Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web

Name of the Procedure:

Reconstruction of toes; syndactyly, with or without skin graft(s), each web
Common name(s): Toe separation surgery, Syndactyly correction surgery

Summary

Toe reconstruction for syndactyly involves surgically separating fused toes and may include the use of skin grafts to cover any gaps. This procedure aims to restore function and appearance to the toes.

Purpose

The procedure addresses congenital or acquired toe fusion (syndactyly). The goals are to improve toe function, enhance cosmetic appearance, and allow for better shoe fitting and walking comfort.

Indications

• Fused toes at birth (congenital syndactyly)
• Acquired toe fusion due to trauma or burns
• Difficulty walking or wearing shoes
• Cosmetic concern due to fused toes

Preparation

• Follow specific fasting instructions, usually no food or drink after midnight before surgery.
• Adjust or discontinue certain medications as advised by the doctor.
• Undergo pre-surgical evaluations such as blood tests, X-rays, or imaging studies.

Procedure Description

1. Anesthesia: General anesthesia is usually administered.
2. Incision: The surgeon makes an incision along the fused area of the toes.
3. Separation: The fused toes are carefully separated using surgical instruments.
4. Skin graft: If there is insufficient skin to cover the separated area, a skin graft may be taken from another body part and grafted onto the toes.
5. Closure: The incisions are closed with sutures and the toes may be dressed with bandages.

Duration

The procedure typically takes 1-2 hours.

Setting

The surgery is usually performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon or plastic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Common risks: Infection, bleeding, scarring
• Rare risks: Nerve damage, graft failure, need for additional surgery
• Management: Antibiotics for infection, follow-up appointments for monitoring and additional interventions if required

Benefits

• Improved toe function and appearance
• Ability to wear shoes comfortably
• Enhanced walking and mobility
• Benefits are usually realized within weeks to months post-surgery as recovery progresses.

Recovery

• Follow post-surgery instructions which may include keeping the foot elevated, wound care, and limited movement.
• Pain management with prescribed medications.
• Physical therapy might be recommended.
• Recovery time varies but typically ranges from a few weeks to a few months.
• Follow-up appointments to monitor healing and remove sutures.

Alternatives

• Non-surgical management like special footwear or orthotics (usually less effective for severe syndactyly).
• Delaying the surgery until necessary.
• Pros: Less invasive, no recovery time.
• Cons: Limited improvement in function and appearance.

Patient Experience

• During the procedure: Under general anesthesia, the patient will be asleep and feel no pain.
• After the procedure: Initial discomfort and pain managed with medication; transient swelling and bruising of toes; possible discomfort while walking, gradually improving.
• Focus on rest, compliance with post-op care, and gradual return to normal activities.