http://jbjs.org/content/98/15/1298
Polydactylism / Supernumerary Digits
A congenital condition characterised by the presence of extra or accessory digit(s) on the hands or feet. The extra digit can be whole, but is often rudimentary and bilateral – may develop from one metatarsal or there may be a complete supernumerary metatarsal.
Cause unknown, but probably genetic – may be irregular autosomal dominant inheritance. Associated with a number of syndromes – Down Syndrome, Lawerence-Moon-Biedl syndrome.
Types/variants:
• Postaxial polydactyly – most common (~80%); Temtamy & McKusick (1969) types: Type A is a fully developed accessory digit and Type B less developed accessory digit (no osseous structures); Venn-Watson (1976) types: complete duplication of metatarsal, Y-shaped metatarsal, T-shaped metatarsal, wide metatarsal head, soft tissue duplication
• Preaxial polydactyl – Temtamy & McKusick (1969) 4 types – duplication of first digit, polydactyly of a triphalangeal first digit, polydactyly of the second digit, polysyndactyly
• Central ray polydactyly
Problems are usually associated with footwear fitting or cosmetic concerns.
Treatment is by surgical removal if indicated – usually at a younger age.
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