Web Space Contracture

Web space contracture refers to the abnormal tightening or shortening of the soft tissues between the fingers or toes, leading to decreased flexibility and impaired movement. This condition commonly occurs following burns, trauma, or surgery, particularly in the hands and feet, and can significantly impact hand function and gait.

Burn injuries affecting the hands or feet can result in scar tissue formation in the web spaces between the fingers or toes, leading to contracture development. Scar tissue has a tendency to contract and tighten over time, causing the adjacent tissues to become immobilized and restricting movement.

Traumatic injuries such as lacerations, crush injuries, or fractures involving the hands or feet can also cause damage to the soft tissues and lead to scar formation and contracture development in the web spaces.

Surgical procedures involving the hands or feet, such as tendon repairs, joint reconstructions, or skin grafts, may also predispose individuals to web space contracture if proper postoperative care and rehabilitation measures are not implemented.

The symptoms of web space contracture may vary depending on the severity and location of the contracture but often include:

• Decreased range of motion: Difficulty spreading the fingers or toes apart fully.
• Stiffness and tightness: Feeling of tightness or pulling in the soft tissues between the fingers or toes.
• Difficulty grasping or walking: Impaired ability to perform fine motor tasks with the hands or maintain balance and stability while walking.
• Pain or discomfort: Discomfort or pain with movement or when pressure is applied to the affected web spaces.
• Visible scarring: Scar tissue may be visible in the web spaces between the fingers or toes, particularly in cases of burn-related contractures.

Management of web space contracture typically involves a combination of conservative measures and surgical intervention, depending on the severity and underlying cause of the condition. Conservative treatment options may include stretching exercises, splinting, or orthoses to help gradually stretch and mobilize the soft tissues in the affected web spaces.

In cases where conservative measures are ineffective, surgical intervention may be necessary to release the tightened tissues and restore normal hand or foot function. Surgical techniques may include scar tissue release, tendon lengthening, or joint reconstruction procedures to improve mobility and alleviate symptoms.