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Polydactyly 755.0

Polydactyly xray

synonyms:

Polydactyly ICD-9

  • 755.0 polydactyly
  • 755.00 polydactyly; unspecified
  • 755.01 polydactyly; of fingers
  • 755.02 polydactyly' of toes

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, associated with other organ system dysfunction in whites.

Polydactyly Anatomy

Polydactyly Clinical Evaluation

  • Exam demonstrates obvious extra digits

Polydactyly Xray / Diagnositc Tests

  • Xray of involved area to evaluate bony involvement

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

  • Kasser JR. The foot. In: Morrissy RT, Weinstein SL, eds. Lovell and Winter's Pediatric Orthopaedics. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:1257-1328.
  • Phelps DA, Grogan DP. Polydactyly of the foot. J Pediatr Orthop. 1985 Jul-Aug;5(4):446-51.
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