Polydactyly is when more than five digits are present in a hand. One of the most common upper limb malformations. Often bilateral,commoner in boys. Incidence is 1:2000 among Caucasians, 1:150 among African Americans.

SYMPTOMS

Extra digits since birth may be located on the 

Medial (ulnar) border, Centre, lateral (radial) border

OPERATIVE PROCEDURE 

 Polydactyly correction depends on its type:

 Type I: soft tissue mass without skeletal structure… Can be exercised under local anesthetic in the first few weeks of life.

Type II: digit contains all normal components

Type III: complete digit with metacarpal. 

 Types II and III: surgical excision and reconstruction of soft tissue elements: ∘ Attachments of the ligaments and muscle (ulnar collateral ligament (UCL) and abductor digiti minimi (ADM) are transferred to the adjacent finger).

FAQS

1. What are the most common complications?

Very few complications, depending on its type, infection, incomplete excision. 

This complication can be easily avoided by performing surgery under loupes magnification, aseptic technique, and postoperative care and by performing operation by properly trained plastic surgeon.

2. At what age should surgery be performed?

Surgery can be performed safely at six months to one year but in Type I, it can be excised under local anesthesia in the first few weeks of life.

3. What is the approximate duration of the procedure?

Few minutes to hours, but it depends on the type of deformity.

4. What setup is required for the procedure?

Day care set up for Type I deformity and In Types II and III, usually patient admits for one to two days.

Written by :  Dr. Afaq Saleem

Copyrights: Pakistan association of Plastic Surgeons