The treatment of extra toes and toe syndactyly often involves the hand surgeon given the overlap in treatment strategies between hand and foot. As I have previously blogged, I typically avoid reconstructing toe syndactyly unless it involves the first web space (ie, the great toe). While there are exceptions to this approach, the risks of […]
Category: Extra Digits (radial polydactyly)
Understanding the Specifics of Upper Extremity Birth Differences, Part 2
It has been far too long since my post on the “Why” of Birth Differences. I apologize and I know at least some of you have been awaiting this post. No excuses but I am now on a new platform and the transition took time. This is Part 2 in which I will review some of the […]
An Unusual Pollicization Procedure
Radial polydactlyly (extra thumb) is a relatively common problem for those of us who treat kids with birth differences/ anomalies of the upper extremity. Please see the following link for previous posts on the topic LINK. Sometimes these can be treated by a “straightforward” procedure with excision of the extra thumb and stabilization of the primary […]
Radial polydactyly- progress and patient follow up
I have shared my thoughts on radial polydactyly (extra thumb) a number of times- those other posts can be found at https://bit.ly/3emosGU. Radial polydactyly is a common diagnosis for those children with birth differences but each child and each extra thumb is also very different. This makes comparing children difficult and results are limited in the […]
Extra Thumb Reconstruction
I have posted a number of times on radial polydactyly- aka split thumb, extra thumb, etc- HERE. This is a common birth anomaly and the decision for surgery is usually straightforward. Sometimes surgery is also straightforward while other times the reconstruction can be quite challenging. And, about one out of three patients with radial polydactyly will […]
Three thumbs
Radial polydactyly (duplicated thumb) is an uncommon condition in the general population- I have blogged about kids with extra thumbs a number of times. Those posts can be found HERE. Extra thumbs come in a wide variety of patterns, some of which are captured in the Flatt Classification (previously called the Wassel Classification) as shown in […]
Adoption and Radial Polydactyly
In 2015 (the most recent year with statistics available), there were 5647 children adopted to parents in the USA. About half of those were from China. See link HERE. I am fortunate to see many families with newly adopted children. In addition, I often have the chance to assess x-rays and clinical information for families before […]
The 5 Finger Hand
The 5 Finger Hand is a rare congenital hand difference which I have written about in this blog once before, HERE.. It is, as it sounds, the presence of 5 fingers, all in the same plane, instead of 4 fingers and a shorter (2 phalanx), palmarly placed thumb. The challenges of the 5 Finger Hand […]
Hand Anomalies and Adoption
Adopted Kids and Polydactyly In 2015 (the most recent year with statistics available), there were 5647 children adopted to parents in the USA. About half of those were from China. https://travel.state.gov/content/adoptionsabroad/en/about-us/statistics.html I am fortunate to see many families with newly adopted children. It is one of the most enjoyable parts of my practice. Sometimes I […]
The Crooked Thumb
The process of limb development is truly amazing and unbelievably complex. Developmental biologists and scientists help to explain these processes and our knowledge grows day by day. As I explain to parents, what is truly remarkable is not that there is a child born with a limb difference but rather that it happen so […]
Extra Digits: functional and social considerations
Today, children born with extra fingers or toes (polydactyly) are typically treated with excision and reconstruction of the hand or foot. There are multiple reasons for the surgical approach. First, the extra digit does not provide a functional advantage. The digits are rarely fully formed or fully functional. Second, the extra digits can cause problems with […]
Outcome after Surgery for an Extra Thumb
The condition of a child born with two thumbs has many, many names but most commonly, we call it radial polydactyly, thumb duplication, or split thumb. While all are utilized, radial polydactyly is the medical term and split thumb is appropriate as both thumbs are smaller than the other thumb. I have posted about radial polydactyly previously […]
The Big Thumb
The term ‘superdigit’ is utilized in congenital hand surgery to describe a digit that is larger than we expect. It is often related to the fusion of two digits into one and may be seen in cleft hand and central polysyndactyly among other conditions. We also see large digits in other conditions such as Macrodactyly. […]
Names Matter: Radial Polydactyly vs Duplicated thumb
There are a number of terms for describing the patient with two thumbs including, ‘duplicated thumb’, ‘extra thumb’, ‘radial polydactyly’, and ‘split thumb’. While the particular term may not seem to matter, it does have important implications. ‘Radial polydactyly’ is a medical term describing the location and anomaly- it is not controversial. ‘Split thumb’ may […]
The Extra Thumb
An extra thumb, or radial polydactyly, can represent a difficult problem in congenital hand surgery. The difficulty is that each child with an extra thumb is somewhat different. There are certainly patterns (as we see with the Flatt Classification system) but not every thumb fits this classification system. Zuidam and all (under the leadership of […]
Thumb Deformity after Polydactyly Reconstruction
Radial polydactyly, an extra thumb, can be more challenging to treat than other types of extra digits. The surgeon cannot simply remove the extra thumb as ligaments need to be recreated and often bones and tendons need to be re- aligned as well. Nonetheless, if the surgeon can create a stable, well- aligned thumb, […]
Central Polysyndactyly
Polydactyly means that more than the normal 5 digits. Typically patients have either an extra thumb or an extra pinky. A patient with radial polydactyly (extra thumb). Syndactyly is the abnormal joining of the fingers. It is most common between the middle digits but can affect any of the fingers. Syndactyly of the fingers. While […]
5- finger hand, follow- up
I have previously posted on the topic of the 5- finger hand. This previous post summarized many of the key issues with this diagnosis. http://congenitalhand.wustl.edu/2013/03/the-5-finger-hand.html Here is the preoperative picture of one such child with a 5- finger hand. Note the small extra thumb and the digits all aligned in the same plane. 5 […]
Extra Thumb
Radial polydactyly is also called split thumbor thumb duplication. Or, an extra thumb if we really want to keep it simple. Extra thumbs all share some similarities but each is really unique. How most patients with radial polydactyly are similar Both thumbs are smaller than the “normal” thumb should be. Many […]
The 5- Finger Hand
The 5- finger hand is a rare anomaly in which there is no thumb, but rather 5 digits in the same plane (i.e., in a row) without a thumb. That means each digit has three bones (whereas the thumb normally has two bones). This is important because the normal thumb function is not present because […]
Difficult Extra Thumbs
As with most medical conditions, congenital anomalies of the upper extremity have a wide range of severity. No two conditions are the same although most can be categorized into groups with similar findings. Patients with an extra thumb (also called duplicated thumb, split thumb, or radial polydactyly) can be severely affected as demonstrated below. These […]
Radial Polydactyly
An extra thumb has been labeled many different ways: ‘radial polydactyly, thumb polydactyly, split thumb, and duplicated thumb’. My preferred name is radial polydactyly as it tells you exactly the issue. The term ‘duplicated thumb’ is not ideal as the thumbs are both smaller than normal but ‘split thumb’ is not perfect either because the […]