Polydactyly

synonyms:

Polydactyly ICD-9

Polydactyly Etiology / Epidemiology / Natural History

• Prexial polydactyly = thumb polydactyly
  
  • Males > females
  • Causcasion > African American
  • Sporadic
• Postaxial polydactyly = duplication of the ulnar most digit
  -Autosomal dominant inheritance
  -Blacks > whites
  -Generally isolated condition in blacks, ossociated with other organ system dysfunction in whites.

Polydactyly Anatomy

Polydactyly Clinical Evaluation

Polydactyly Xray / Diagnositc Tests

Polydactyly Classification / Treatment

• Wassel Classification (Wassel HD, CORR 1969;64:175).
• Wassel Type I: bifid distal phalanx
• Wassel Type II: duplicated distal phalanx
• Wassel Type III: bifid proximal phalanx
• Wassel Type IV: duplicated proximal phalanx
• Wassel Type V: bifid metacarpal
• Wassel Type VI: duplicated metacarpal
• Wassel Type VII: thumb polydactyle with associated triphangeal thumb
• Treatment: ablation of the radial thumb with radial collateral ligament reconstruction and advancement of the thenar insertions to the retained ulnar thumb. +/- corrective osteotomies as indicated.
• Postaxial
  -Type A(fully developed): ecsion with collateral ligament and hypothenar muscle reconstruction.
  -Type B (rudim entary and pedunculated): consider suture ligation in newborn nursery

Polydactyly Associated Injuries / Differential Diagnosis

• Associated congenital anomalies are rare

Polydactyly Complications

• Late deformity

Polydactyly Follow-up Care

Polydactyly Review References

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