Polydactyly

Polydactyly is a congenital difference in which a finger or toe is partially or completely duplicated.

Duplication most often affects the thumb or the fifth digit, commonly called the little finger or little toe.

Yes. It may involve one or more phalanges and may extend into a metacarpal bone in the hand or a metatarsal bone in the foot.

No. Often neither duplicated digit is completely healthy, and one may be noticeably smaller or less developed.

Surgery involves carefully removing the extra digit and, when necessary, correcting joint problems in the digit that is preserved.

Yes. When the joints are affected, some limitation of movement may remain even after surgical correction.

Yes. Polydactyly may occur on the thumb or great-toe side, on the fifth-digit side, or centrally. Its location and the tissues involved help determine treatment.

Diagnosis is usually made by inspection and clinical examination. An X-ray shows whether bones and joints are duplicated and how the extra digit connects to the hand or foot, which helps with treatment planning.

It may occur on its own and can run in families. In some children it is associated with other congenital differences or a syndrome, so additional assessment may be considered when there are other clinical findings or a relevant family history.

It can. An extra or misaligned toe may make ordinary footwear difficult to fit or cause discomfort when walking. Treatment decisions consider anatomy, alignment, symptoms and foot function.

No. A small duplication made mainly of skin and soft tissue requires a different approach from a digit containing bone, joints, tendons, ligaments, nerves and blood vessels. The plan is tailored to each child.

There is no single age for every child. Timing depends on the type and complexity of the duplication; many corrections are planned in infancy or early childhood, and reconstruction of a duplicated thumb is often performed after about one year of age.

This depends on the child’s age and the complexity of the duplication. Selected infants with a simple additional little finger may be treated under local anaesthesia, while more complex reconstruction is usually performed under general anaesthesia. Many procedures are outpatient, but the plan is individualised.

Simple duplications may require only a dressing and wound care. Complex cases may need a cast or temporary pin to protect the reconstruction, with follow-up visits and sometimes X-rays. The team will also explain scar care and whether hand or occupational therapy is needed.

Possible risks include bleeding, infection, wound-healing problems and a permanent scar. Stiffness, limited movement, residual angulation or instability may also remain. Further surgery may be needed in some complex cases, particularly if growth reveals residual problems.