Polydactyly, a condition where an individual has extra fingers or toes, is one of the most common limb differences. It typically involves a person being born with six fingers on one or both hands or six toes on one or both feet, a condition known as polydactyly foot when it affects the lower extremities. While generally harmless, this condition can lead to challenges with movement, footwear, and occasionally, other development-related issues. Here, we explore what polydactyly looks like, its causes, and available treatments, including polydactyly toes surgery.

What Does Polydactyly Look Like?

Polydactyly varies in presentation, affecting one or both feet or hands, although it is less common for it to impact all four. The extra digit is usually not fully developed and may appear as a small, partially formed finger or toe that lacks the full range of motion.

These extra digits can be:

• Skin and Soft Tissue Only: Some additional toes are simply protruding skin or soft tissue. These may be small bumps or larger protrusions.
• Bone and Joint Structure: In other cases, the extra toe may include skin, bone, and even a joint, giving it a more digit-like appearance. These tend to be larger and closer in structure to typical toes.

Types of Polydactyly in Feet

Polydactyly is classified based on the location of the extra digit on the foot:

• Preaxial Polydactyly: The extra toe is positioned next to the big toe, also known as tibial polydactyly.
• Postaxial Polydactyly: The extra toe is located beside the little toe, often referred to as fibular polydactyly.
• Central Polydactyly: This type features an extra toe positioned between other toes, a less common form than the others.

What Causes Polydactyly Foot?

Polydactyly develops early in pregnancy when the baby’s fingers and toes begin to separate, usually around the sixth week. Sometimes, instead of forming a single finger or toe, a digit divides, creating an extra. While this condition may be genetic, it frequently occurs without any family history and without any related health complications.

However, polydactyly may occasionally be associated with certain syndromes, such as McKusick-Kaufman syndrome or Bardet-Biedl syndrome, where polydactyly is one symptom among other developmental differences. Your child’s doctor can discuss whether any additional testing is required based on other symptoms.

Treatment Options for Polydactyly Foot

In many cases, an extra toe does not interfere with function or health. However, if it does impact movement, growth, or footwear, polydactyly toes surgery is often recommended for children between ages one and two. This allows the child to develop normal foot function and reach their mobility milestones without limitations.

Evaluation Before Surgery
To plan the best approach, the doctor will perform a detailed examination and may request an X-ray. This helps determine whether the extra toe contains bones, joints, or simply soft tissue, which in turn dictates the surgical approach.

Surgical Techniques for Polydactyly Toes Surgery

1. Vascular Clip Technique: When the extra toe consists only of skin and tissue, a vascular clip may be used to tie off the base of the extra toe. This cuts off blood supply, allowing the extra skin to shrink and detach on its own. This process is similar to how a newborn’s umbilical stump naturally falls off.
2. Standard Surgery: When the extra toe includes bone or ligaments but does not impact the function of other toes, the doctor can remove it with a straightforward procedure. After removal, the child will usually wear a splint or cast for support as the foot heals.
3. Reconstructive Surgery: For more complex cases, where the extra toe has bones or tendons affecting the function of adjacent toes, more intricate surgery may be required. The doctor will carefully remove the extra digit and reposition any bones, tendons, or ligaments to ensure optimal foot functionality. Recovery may also involve physical or occupational therapy to help the child strengthen and adapt to their restructured foot.

Recovery and Follow-Up Care

The recovery from polydactyly toes surgery is usually smooth, especially with early intervention. After surgery, the child may wear a cast or splint to protect the foot as it heals. In some cases, additional surgeries may be required as the child grows, particularly if there are structural adjustments needed for balance or comfort.

Final Thoughts: Why Seek Professional Care?

For children born with polydactyly, prompt evaluation by a qualified professional ensures the best possible outcome. Early surgical intervention can not only enhance mobility but also prevent potential complications with gait or footwear. Addressing this condition at a young age helps children develop naturally, without hindrances to their growth milestones or everyday comfort.