Lawrence Silverbergthe Internet home of Drs. Emanuel Sergi and Lawrence Silverberg, the most compassionate and skilled foot doctors in the New York City Metro area and the country.

Dr. Silverberg is Board Certified by the American Board of Podiatric Surgery. Our office is conveniently located in Midtown Manhattan near Grand Central Station.

We take great pride in providing excellent medical care along with great bedside manner and take the extra time to explain your problems and the treatment options in detail.

At City Footcare we treat all problems related to the foot and ankle. We use state of the art diagnostic and therapeutic equipment.

The doctors believe in patient education, and patient participation in their care. We take pride in spending time with our patients and listening to them. Our patients never feel rushed. We also take the time to explain patients’ problems in detail and spell out explicit treatment plans.

When your problem requires surgery, you can rest assured that you are in the hands of competent and highly trained surgeons. Drs. Sergi and Silverberg have been called the best foot surgeons in NYC and the best bunion surgeons in NYC. The doctors perform all foot and ankle surgery including traditional open surgery, minimally invasive surgery, laser surgery, radio frequency surgery and extra-corporeal shock wave therapy. Drs. Sergi and Silverberg are experts in all aspects of foot surgery. They are very detail oriented from start to finish. A good surgical outcome starts prior to entering the operating room. After expertly diagnosing patients’ conditions, they plan out the procedures with great skill. In the operating room they are skillful and precise. They also take into consideration aesthetics with incision planning and plastic surgery type suturing techniques.

They are hospital and surgery center affiliated.

To resolve all of your foot and ankle problems, simply look around this site and make an appointment with Drs. Sergi and Silverberg today. Your feet will be glad you did!

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Congenital duplication of digit, webbed toes, Six toes or four toes, you decide

I had a very nice young lady come in with a complaint of bunion pain.

Webbed Toes

The interesting part of this case though, is not the bunion but a congenital abnormality she had.  She had webbing of her second and third toe with duplication of parts of the second toe.  What does this mean?  I think the pictures will explain it much better than words, see below: (click any picture to enlarge)


Above, you can see the bunion and the congenital abnormality.  There are two nails on the second digit and webbing of the skin between the second and third digit.  When you see two separate nails you can assume there is duplication of the distal bones as well because the nails are attached to the distal phalanx bones.


In the above x-ray you can see the normal bones of the third toe with three bones, the proximal phalanx, middle phalanx and distal phalanx.  You can see the bunion.  You can see the two distal phalanx bones and the middle phalanx have all fused into one large bone of the second digit.

Having extra toes (or fingers) is called polydactyl.  It is a congenital anomaly and can be hereditary (runs in families) but not always.  Treatment depends on the presentation and is usually optional.  If there are concerns from the parents of future disability or shoe fitting problems surgery is often performed as an infant.  Surgery also depends on which toe is duplicated.  In the above patient, surgery would rarely be performed due to difficulties making the toes look normal.  The nails are virtually impossible to combine.  I’ve done surgery to remove the webbing of the toes using skin flaps and skin grafts.  Surgery is much more often performed when there is duplication of the first or fifth digit which tend to make fitting shoes difficult and have an excellent cosmetic prognosis.

© Copyright 2010
Best Podiatrist NYC
Lawrence Silverberg, DPM
City Footcare, PC
20 E 46th Street
New York, NY 10017
Specializing in foot surgery, bunion surgery, hammertoe surgery, cosmetic foot surgery, general podiatric surgery.
4 Responses to Congenital duplication of digit, webbed toes, Six toes or four toes, you decide
  1. Jen
    September 16, 2011 | 6:44 pm

    I have the same condition. My 2nd and 3rd toe are only slightly webbed. My 2nd toe has 2 toenails, however, I was told there is only one distal phalanx bone.
    What is this condition called????? I no of no one else in my family, nor did I pass it on to my childen. Is it genetic????? I am 33 years old and have always wondered and none of the doctors I have seen over the years for other conditions who just happen to see my toe know what it is. I am so curious.

    • drsilver
      August 20, 2012 | 2:15 am

      Hi Jen.

      The condition is called polydactyly and there are many different kinds depending on which bones and soft tissue structures are duplicated or not.

      It is usually congenital but often times it is not too.

      Dr. S.

  2. Dino
    June 20, 2012 | 6:56 pm

    I have a similar condition without the bunion and the web toes.

    You’ve mentioned that surgery would rarely be performed due to difficulties making the toe look normal.

    If I decide I want to have the toe corrected as close to normal as possible, how long will recovery take and how much would the procedure cost?

    • drsilver
      July 20, 2012 | 11:43 pm

      Hi Dino. I usually refer Patients to plastic surgeons when they require more advanced skin flap procedures. You’ll need to ask the doctor to answer your questions of costs and recovery after youre evaluated.

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