Polydactyly | Diagnosis & Treatment

How is polydactyly diagnosed?

Polydactyly can be seen by ultrasound prenatally and by eye at birth. Your doctor will use x-rays to assess the underlying structure of your baby’s finger and determine a course of treatment.

What are the treatment options for polydactyly?

Our hand and upper extremity experts and plastics experts usually treat children with polydactyly by surgically removing the extra finger — typically, when the child is between 1 and 2 years old — young enough that developmental milestones won't be missed, such as grasping (prehension), but late enough that anesthesia and surgery can be tolerated.

Removing an extra little finger (ulnar polydactyly) can be fairly simple if the extra finger is attached by a narrow “stalk” or “nub” of soft tissue. The extra finger can be removed with a minor procedure or even by tying off (ligating) the nub in the nursery.

Removing an extra thumb (radial polydactyly, thumb duplication) can be complex. The thumb is of primary importance in hand function, and radial polydactyly can negatively impact thumb position (angle), shape and function. Removing the extra thumb is sometimes not enough—the procedure can also require remodeling of the remaining thumb, with care and attention to soft tissues, tendons, joints and ligaments. And even after treatment, the reconstructed thumb may be smaller than normal. Read more about the treatment and care for thumb duplication.

Removing an extra central finger (central polydactyly) is typically complex, involving significant reconstruction of  the hand, and also taking care with soft tissues, tendons, joints and ligaments. Sometimes more than one surgery is needed. 

If the surgery to remove the extra digit is fairly complex, it can also involve your child's bone, ligament and tendon. If that's the case, your child may need to wear a cast for a few weeks. Your doctor may recommend occupational or physical therapy to help reduce scarring, stiffness and swelling and improve function.

What is the long-term outlook for polydactyly of fingers?

Most of our young patients recover full hand function and an improved appearance of their hand. If needed, your child's team will work with you and your child to learn home exercises that are important to his recovery. He may need to wear a cast or splint in some circumstances. It is possible that in a severe case, your child may need additional reconstructive surgery(ies) to recover full function and improve the hand's appearance.

Your child may need to be followed for a number of months or years to:

  • ensure that the healing has gone well
  • check that function has returned to your child's hand
  • determine whether additional surgery is needed to improve the function or appearance of the hand as your child grows