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Congenital polydactyly: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Congenital polydactyly is a developmental defect characterized by a quantitative increase in individual segments of the finger or the ray 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 divided into polyphalangy, polydactyly and ray doubling. By localization, radial (or preaxial), central and ulnar (or postaxial) polydactyly are distinguished. Polydactyly of the first ray of the hand is most often diagnosed. In the overwhelming majority of cases, polydactyly of the thumb is combined with 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 skin bridge, it can be removed in the first months of life. In other cases, age indications shift to the 1st year of life. When choosing a method of surgical treatment, an essential requirement is a clear understanding of which finger is the main one and which is additional. According to the literature, in 71.4% of cases, after simple removal of the additional phalanx, secondary deformations of the main finger are formed during growth. According to our observations, only 33% of patients with radial polyphalangy, polydactyly and doubling of the ray did not have pathology of the main finger. In other cases, deformations of the main segment are noted in the form of hypoplasia, clinodactyly, flexion contracture or syndactyly of the main 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 examining the condition 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 case of polydactyly:
- removal of an additional segment without intervention on the main finger:
- removal of the additional segment with correction of the deformation of the main finger without using or using the tissues of the additional segment:
- removal of an additional segment using its tissues to reconstruct other fingers of the hand.
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