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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