Web creep, the most common complication of this procedure, is the distal migration of the web commissure seen in surgically corrected syndactyly patients. It is caused by abnormal scar tissue formation and increasing growth of underlying osseous structures. Informing parents of this complication preoperatively is advised.
Deunk et al reviewed the long-term results of 27 patients treated with either STSG or FTSG at 21 years. The STSG group had increased flexion and extension lags but decreased finger abduction and increased graft breakdown. The FTSG had higher rates of web creep, hyperpigmentation and hair presence. The authors did not favor one technique over the other.
Ricterman et al performed a radiographic analysis of web height in children. They were able to radiographically determine a standard web height quantification system using anatomic landmarks. This technique serves as the foundation for measuring web creep in syndactlyly.
Illustration A is a clinical photo demonstrating web creep as a late complication.
Deunk J, Nicolai JP, Hamburg SM. Long-term results of syndactyly correction: full-thickness versus split-thickness skin grafts. J Hand Surg Br. 2003 Apr;28(2):125-30.
PMID:12631483 (Link to Abstract)
Richterman IE, DuPree J, Thoder J, Kozin SH. The radiographic analysis of web height. J Hand Surg Am. 1998 Nov;23(6):1071-6.
PMID:9848561 (Link to Abstract)