Congenital polydactyly: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Congenital polydactyly is a developmental disorder characterized by a quantitative increase in individual segments of the finger of the hand or the beam as a whole (the ray is all the phalanges of the finger and the corresponding metacarpal bone). Depending on the level of doubling, this anomaly is subdivided into polyphalange, polydactyly and doubling of the ray. Localized radial (or preaxial), central and ulnar (or postaxial) polydactyly. The most frequently diagnosed polydactyly the first ray of the hand. In most cases, the polydactyly of the thumb of the hand is combined with the deformation of the main and (or) additional segment.
ICD-10 code
- Q69.0 Congenital polydactyly.
Treatment of congenital polydactyly
Treatment is surgical. In cases where the additional finger is connected to the main finger by a thin dermal bridge, it can be removed already in the first months of life. In other cases, the age indications are shifted to the 1 st year of life. When choosing the method of surgical treatment, an essential requirement is a clear understanding of which finger is the main one, and what is additional. According to the literature, in 71.4% of cases after a simple removal of an additional phalanx during the growth, secondary deformations of the primary finger are formed. According to our observations, only 33% of patients with radial polyphalangey, polydactyly and doubling of the ray had no abnormality of the main finger. In other cases, deformations of the main segment in the form of hypoplasia, clinodactyly, flexural contracture or syndactyly of the primary and additional fingers, or a combination of these anomalies. In this regard, the widespread practice of removing an additional segment at an early age without studying the state of the main finger should be considered unacceptable.
The nature of surgical intervention, depending on the degree of underdevelopment of the main and additional segments of the finger in the case of polydactyly:
- removal of an additional segment without interventions on the base finger:
- removal of an additional segment with correction of deformation of the main finger without using or using the tissues of an additional segment:
- Removing an additional segment using its tissues to reconstruct other fingers of the hand.
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