Polydactyly of the Hand:    

- See:
      - Polydactyly of the Thumb:
      - Polydacyly of the Foot:

- Discussion:
    - polydactyly is most common hand anomaly;
    - may involve autosomal dominant transmission in which case an asociatted syndrome is generally not present;
          - when a genetic syndrome is present, transmission tends to occur in a recessive pattern;
    - central polydactyly is often inherited w/ an associated with syndactyly;
    - about 10 times more common in blacks than whites;
    - polydactyly of one or more supernumerary digits is most often post-axial involving an extra little finger;
    - although pts function well, the deformity is unacceptable cosmetically in many cultures;

- Exam:
    - digits may be abnormally short (brachydactyly), a consequence of short or missing phalanges;

- Classification:
    - type I:   extra soft tissue only (treated w/ ligation in nursery)
    - type II:  includes bone, tendon, and cartilage;
    - type III: completely developed with own metacarpal (rare);

- Radiographs:  

- Treatment: Post-Axial Nubbin:
    - if radiograph demonstrates no bone in the post axial duplicated digit, it may be removed in the newborn nursery, through ligation;
         - note: suture ligation is not usually performed in older infants;
    - w/ more developed digit, formal surgical amputation should be performed;
    - good web space should be preserved and the digit removed;
    - w/ polydactyly of the small finger, the abductor digiti minimi needs to be attached to the retained digit

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, September 8, 2011 1:55 pm