Presentation
Malformations presented by the patient cannot be included in any of the current classifications for polydactyly, because they are complex and widespread, leaving no place to site exceptional cases such as the one presented. [faoj.org]
Either can present unilaterally or bilaterally. [consultant360.com]
Myopia is sometimes present. The ERG reveals generalized rod and cone dysfunction in some eyes, but may be normal in others. In many eyes the ERG is nonrecordable. Cataracts are frequently present. [disorders.eyes.arizona.edu]
When presenting as an isolated condition, polydactyly can be a correctable issue with a good outcome. Summary Preaxial polydactyly: Thumb or great toe side extra digit. [adoption.umn.edu]
This book presents the most common site-specific pediatric orthopedic problems seen in clinical practice. [books.google.com]
Entire Body System
- Swelling
The treating physician should be informed of any post-operative swelling, severe pain, fever, or fingers that tingle, are numb, or have a bluish discoloration. [surgeryencyclopedia.com]
Initially, Tylenol or Ibuprofen, or icing, can help reduce the swelling, pain and inflammation. Sometimes, taping both the normal and extra toes can be helpful. The extra digit serves no functional purpose. [stepalivefootandanklecenter.com]
Polydactyly foot surgery complications include, but are not limited to: infection, pain (temporary or permanent), swelling, hematoma, bleeding, blood clot, poor wound healing, incision breakdown, poor bone healing (delayed union, nonunion), malunion, [bunionsurgeryny.com]
Some children who have extensive surgery with cutting through many tissues may have occupational therapy to help with swelling, scarring and stiffness. [seattlechildrens.org]
- Fever
The treating physician should be informed of any post-operative swelling, severe pain, fever, or fingers that tingle, are numb, or have a bluish discoloration. [surgeryencyclopedia.com]
- Soft Tissue Mass
The extra index finger may consist of a pedunculated soft-tissue mass or it may have normal bony and soft-tissue components. [boneandspine.com]
Skin
- Flushing
[…] duplication (complete or partial); - over 90% of patients should have a good to excellent surgical result; - surgical resection involves excision of the lateral toe in the majority of cases; - if the metatarsal head is prominent, it should be trimmed flush [wheelessonline.com]
Any duplication of the metatarsal is removed flush with the remaining bone. If complete duplication of a metatarsal is present, then a ray resection may be preferred. [musculoskeletalkey.com]
Musculoskeletal
- Foot Deformity
SEP 2000; 51 (9) : 685-687 Carranza-Bencano-A; Gomez-Arroyo-JA; Fernandez-Torres-JJ; Moya-Corral-F Foot deformities associated with Apert syndrome [letter] J-Am-Podiatr-Med-Assoc. 2000 Jun; 90(6): 322-4 Foucher-G; Medina-J; Navarro-R; Pajardi-G Value [malattierare.regione.veneto.it]
Multiplanar supramalleolar osteotomy in the management of complex rigid foot deformities in children. J Child Orthop. 2009 Feb. 3 (1):39-46. [Medline]. [Full Text]. [emedicine.medscape.com]
Keywords: Diplopodia, mirror foot, polydactyly MeSH terms: Congenital abnormalities, supernumerary organs, foot bones, foot How to cite this article: Vlahovic AM, Pistignjat BS, Vlahovic NS. Nine toes; Mirror Foot Deformity. [ijoonline.com]
The result is shortening and angular deformity.43,44 When it occurs in the first metatarsal, the result is varus deformity.45 The longitudinal epiphyseal bracket is present in 2 to 14 percent of congenital foot and hand deformities.46 This lesion has [podiatrytoday.com]
- Osteoporosis
Gallen P103 Co-Treatment of Osteoporosis in elderly Fracture Patients : a Need without Burden for our Budget! Poster A09 N. Suhm Universitätsspital Basel Vortragender M. Jakob E. Kungler L. Studer [organizers-congress.org]
Psychiatrical
- Psychomotor Retardation
There are several types of polydactyly, of varying frequency: Polydactyly alopecia seborrheic dermatitis Polydactyly cleft lip palate psychomotor retardation Polydactyly myopia syndrome Polydactyly postaxial dental and vertebral Polydactyly postaxial [fetalultrasound.com]
Workup
July 15, 2011), a database of human genes and genetic disorders, and syndromic polydactyly is commonly an autosomal recessively inherited trait. 4 Because hand and foot polydactyly are associated with congenital defects in 23.4% of patients, a genetic workup [clinicaladvisor.com]
Since it is a condition that is generally uncommon in Caucasians, genetic workup should be considered in a Caucasian child with polydactyly. Preaxial Polydactyly : Preaxial polydactyly means that the extra digit(s) is on the thumb or big toe side. [adoption.umn.edu]
Treatment
Usually, your baby won’t need any special treatment or therapy prior to surgery. [muhealth.org]
Currently, there is no standard protocol on the treatment of heptadactylia. [journals.lww.com]
Septic suppurative arthritis 578 44 Juvenile rheumatoid arthritis 581 45 Tumors 585 452 Benign bone tumors and tumorlike lesions 595 453 Malignant bone tumors 611 454 Soft tissue tumors 622 455 Therapeutic strategies for bone and soft tissue tumors 631 Treatment [books.google.com]
Treatment Treatment Options: No treatment has been reported. [disorders.eyes.arizona.edu]
Treatment Options The most important goal of any treatment for hand malformations is to help a child function as independently as possible. [healthychildren.org]
Prognosis
[…] the upper extremity 485 357 Fractures of the upper extremities 494 358 Tumors of the upper extremities 522 41 Traumatology basic principles 532 413 Diagnosis 533 414 Special injuries 536 415 Therapeutic principles 540 416 Followup management 543 418 Prognosis [books.google.com]
An autosomal dominant pattern of transmission is also associated with a favorable prognosis. [roentgenrayreader.blogspot.com]
Prognosis The prognosis for isolated polydactyly is excellent. When polydactyly is associated with another genetic syndrome, the prognosis is dependent on the presence of other features of that syndrome. [encyclopedia.com]
[…] non-syndromic macrodystrophia lipomatosa syndactyly : most common associated limb anomaly, it is then termed polysyndactyly If it is an isolated anomaly it is incidental and not of concern but if associated with another anomaly it then carries a vastly variable prognosis [radiopaedia.org]
Surgery Excision of the least developed digit, with preservation of the UCL and osteotomy, if indicated Follow-up Prognosis Rudimentary, type-B postaxial polydactyly: Good Other types of polydactyly (type A, duplicated thumb): Possible risk of angular [orthopaedicclinic.com.sg]
Etiology
The etiology of sporadic PPD1 remains largely unknown and the relative contribution of genetic and environmental factors is not clearly defined. [bmcpediatr.biomedcentral.com]
Etiology The cause is unknown, unless the condition is associated with a syndrome. [orthopaedicclinic.com.sg]
[…] suggests that the foot is duplicated and the supernumerary toes do not have to be in the mirror duplication. [8] Khan et al. stated that diplopodia has to be differentiated from polydacyly, where accessory tarsal or metatarsal bones are not seen. [13] Etiology [ijoonline.com]
Etiology The origin of polydactyly appears to be genetic. Thirty-nine percent of patients’ charts that Venn-Watson reviewed noted a positive family history of polydactyly ( 3 ). [musculoskeletalkey.com]
Etiology Polydactyly may occur as an isolated trait or in conjunction with certain syndromes, and there is a positive family history in 30% of cases. [emedicine.medscape.com]
Epidemiology
VI: Duplicated metacarpal Central Postaxial (involving small finger or toe): Type A: Complete duplication with bony attachment to an adjacent digit Type B: Rudimentary, incomplete duplication of the phalanges Synonyms: Accessory digits, Split thumb Epidemiology [orthopaedicclinic.com.sg]
The goals of this work are twofold: (1) to examine the clinical features and the epidemiology of sporadic PPD1 in Poland, and (2) to compare epidemiologic characteristics of sporadic PPD1 with the familial forms of isolated polydactyly (more likely attributable [bmcpediatr.biomedcentral.com]
They added that diabetes in the mothers pointed to a possible genetic predisposition interacting with teratogenic effects of poor glycemic control. [18] Epidemiology The incidence of polydactyly is 1.7 cases per 1000 live births. [emedicine.medscape.com]
Clinical and genetic epidemiology of Bardet-Biedl syndrome in Newfoundland: a 22-year prospective, population-based, cohort study. Am J Med Genet A. 2005;132:352-60. Karmous-Benailly H, Martinovic J, Gubler MC, et al. [rarediseases.org]
For instance, a distorted sex ratio in certain syndactylies is very puzzling. 16 Large epidemiological surveys in various populations would be helpful in the evaluation of sex distortion and revisiting the prevalence estimates of various syndactyly types [nature.com]
Pathophysiology
Removing the extra digit through disarticulation is the standard treatment. [4, 11, 12, 13] Pathophysiology Polydactyly may be divided into three broad categories as follows: Postaxial polydactyly (lateral ray) Preaxial polydactyly (medial) Central polydactyly [emedicine.medscape.com]
Bardet-Biedl syndrome: Genetics, molecular pathophysiology, and disease management. Indian J Ophthalmol. 2016;64(9): 620-627. Hufnagel RB, Arno G, Hein ND, et al. [rarediseases.org]
Prevention
This helps prevent scarring and shortening of tissue, called contractures. The length of time a child wears a splint varies, depending on the severity of the condition. [nyulangone.org]
The expression of SHH gene in the posterior region is promoted by polarity, which prevent cleavage of GLI3 into its suppressed form. [news-medical.net]
If there is flat foot then a shoe insert may help to prevent its progression. Surgery may be recommended only in severe cases. [cityortho.co.uk]
• Splints or Pads: Specific pads may prevent pressure and physical irritation in shoes. Polydactyly Reconstruction Surgery in the Foot Depending on the toe involved and severity there are various approaches to fixing the problem. [bunionsurgeryny.com]
any amount of varus is considered abnormal, and the patient's symptoms often correlate w/ the degree of varus; - patient's often note difficulty w/ shoe wear and pain; - if hallux varus deformity is present, then consider an AFO which is molded to prevent [wheelessonline.com]