Updated: 6/15/2021

Oligodactyly

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  • Summary
    • Oligodactyly is a rare congenital condition caused by improper differentiation of the apical ectodermal ridge during 1st trimester of pregnancy that presents with absence of one or more toes.
    • Diagnosis is made with the absence of one or more toes, most commonly on the lateral aspect of the foot.
    • Treatment is observation. 
  • Epidemiology
    • Incidence
      • less common than polydactyly
    • Anatomic location
      • lateral rays are affected more often than the hallux
  • Etiology
    • Pathophysiology
      • pathoanatomy
        • due to improper differentiation of the apical ectodermal ridge during 1st trimester of pregnancy
      • thought to be caused by
        • teratogenic insults
        • impaired blood flow
        • amniotic bands
    • Genetics
      • positive family history in some cases
      • sporadic in others
    • Associated conditions
      • orthopaedic
        • fibular hemimelia
        • tarsal coalition
        • hand & foot abnormalities
          • polydactyly
          • syndactyly
          • constriction rings
          • brachdactyly
      • medical
        • associated with a number of syndromes including
          • VACTERL
          • Fanconi
  • Presentation
    • Physical exam
      • absent digits
    • Symptoms
      • usually painless
      • may present with discomfort during shoe wear
  • Imaging
    • Radiographs
      • recommended views
        • AP of the foot
  • Treatment
    • Nonoperative
      • observation alone
        • indications
          • mainstay of treatment as there is usually no limitation in function
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