Dr Steve Carter
Polydactyly comes from the Greek word meaning many fingers.
According to Swanson’s Classification polydactyly falls into the category of duplication.
The condition is common in South Africa, affecting approximately 1 in 500 births and is often hereditary, particularly along the maternal side. It is rarely associated with Syndromes, however as in all congenital cases this is screened for.
Polydactyly can be divided into 3 major types:
- Ulna or post axial polydactyly.
- Radial or pre-axial polydactyly.
- Central polydactyly.
The radial polydactyly is dealt with under thumb duplications on the website.
Ulna polydactyly is the most common type, in this variety the extra finger is on the side of the little finger. The extra finger may be a simple nubbin attached to the little finger which is very simply surgically removed with an elliptical incision. Traditional teaching has focused on tying a suture around the nubbin and allowing it to fall off. I do not practice this approach as one is left with an unsightly residual piece of nubbin on the little finger and this often becomes irritating when the child starts to write.
The ulna polydactyly may also present as a fully formed digit. Again this is addressed surgically whereby the digit and bone is removed, very often a collateral ligament reconstruction needs to be done.
Surgery in these children is done at approximately one year of age and one can achieve a very satisfactory outcome for parents and child.