Polydactyly

Polydactyly is a condition in which an extra finger or toe is present on the hand or foot. It is the second most common hand anomaly and is present from birth (congenital). Polydactyly usually affects only one hand or foot rather than both.

There are three types of polydactyly that are distinguished based on the location of the extra finger or toe:

  • Pre-axial polydactyly — the extra digit is located outside the thumb (radial polydactyly) or big toe (tibial polydactyly)
  • Post-axial polydactyly — the extra digit is located outside the little finger (ulnar polydactyly) or little toe (fibular polydactyly)
  • Central polydactyly — the extra digit is located in between other fingers or toes

The Center for Plastic and Reconstructive Surgery offers a full range of surgical procedures for polydactyly. Surgeons use leading-edge technology and world-class surgical techniques.

Symptoms

The main symptom of polydactyly is an extra finger or toe. The condition can range from a small extra bump on the side of the hand to a finger that widens to end in two fingertips, an extra finger that dangles by a thin cord from the hand or a hand that has a thumb and five fingers.

Diagnosis

To diagnose polydactyly, the physician will perform a physical examination and discuss the symptoms with patients and their families. The physician will look for symptoms of other conditions that may be causing the polydactyly. X-rays are used to see the bone structure of the hand or foot in order to determine how the extra digit is attached. Blood tests may also be performed to screen for genetic conditions.

Treatments

Polydactyly is usually treated in early childhood with the removal of the extra finger or toe. If the extra digit is not attached by any bones, a vascular clip may be used to remove it. The vascular clip attaches to the extra digit and cuts off blood flow to it. After a short time the extra digit will fall off similar to how a newborn baby's belly button stump comes off.

When surgery is needed it may be complicated because the extra digit, as well as the hand or foot it is attached to, may have unusual internal structures. This may include twisted bones, crooked joints, or missing or extra tendons, nerves and blood vessels. Abnormalities in the fingers or toes that are kept may be more obvious after surgery than before, but with careful planning, the surgeon can anticipate and correct these problems at the time of surgery.

After surgery, protecting the hand or foot in a large bandage is usually necessary for a few weeks to months, depending on what type of surgery was performed. Surgery performed in childhood may need to be adjusted for growth with touch-up surgery when the child is older.

The knowledgeable and highly trained staff at the Cedars-Sinai Orthopedics Center and Hand Surgery Program will work with each patient to determine the best treatment option.