Updated: 10/11/2016

Polydactyly of Foot

Review Topic
2 2
4 4
https://upload.orthobullets.com/topic/4078/images/photo 1.jpg
https://upload.orthobullets.com/topic/4078/images/photo 2.jpg
  • Extra digits of the toe
  • Epidemiology
    • incidence
      • occurs in 1 in 500 births
      • postaxial (lateral side of the foot) polydactyly is most common 
    • demographics
      • more common in African-Americans than caucasians
  • Pathophysiology
    • failure of differentiation in the apical ectodermal ridge during first trimester of pregnancy
  • Genetics
    • usually transmitted as autosomal dominant (positive family history) 
  • Associated conditions
    • orthopaedics manifestations
      • may involve extra phalanges or even duplicated rays  
  • Prognosis
    • natural history of disease
      • may cause problems with shoe fitting and angular deformity of the toes
  • Venn-Watson Classification of Polydactyly 
    • post-axial (lateral side of the foot)
      • 'Y' metatarsal
      • 'T' metatarsal
      • wide metatarsal head
      • complete duplication
    • central (not part of the original classification)
      • duplication of the second, third or fourth toe
    • pre-axial (medial side of the foot)
      • short block first metatarsal
      • wide metatarsal head
  • Physical exam
    • extra digits in the foot
  • Radiographs 
    • metatarsals are present on radiographic views at birth, but generally radiographic evaluation delayed to allow full ossification of the phalanges for surgical planning
  • Nonoperative
    • observation
      • indications
        • postaxial or central polydactyly
          • with proper alignment of the digit may remain in place unless the foot is significantly widened (rare)
  • Operative 
    • ablation of extra digit (usually border digit)
      • indications
        • malaligned toe, particularly preaxial polydactyly
          • perform at 9-12 months of age if possible
          • small skin tags can be removed in newborn nursery

Please rate topic.

Average 3.0 of 15 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Questions (2)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Evidences (4)
Topic COMMENTS (0)
Private Note