Surgical management of an exceptionally rare case of symptomatic central polydactyly in an adolescent
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262052Keywords:
Central polydactyly, Bifid extensor, Adolescent, Surgical technique, Osteotomy, OutcomeAbstract
Central polydactyly is the rarest form of digital duplication, representing only 5-15% of all cases23-06-2026 15:35:00. We report the case of a 13-year-old girl presenting with symptomatic central polydactyly (Wall type 1 A) with late-onset pain and functional limitation. Radiographic evaluation demonstrated a bifid third metacarpal consistent with Tada type II classification. Surgical management involved resection of the supernumerary digit combined with a subtraction osteotomy of the third metacarpal and intertendinous suturing to restore axial alignment and centralize the extensor mechanism. At 3-year follow-up, the patient demonstrated excellent functional and aesthetic outcomes. This case highlights the importance of addressing both skeletal deformity and tendon imbalance in delayed presentations of central polydactyly.
References
Liu Y, Xu X, Wang L, Lao J, Zhuang Y, Fang Y. Resection and reconstruction for radial polydactyly type IV-D in 206 cases: a retrospective clinical analysis. BMC Musculoskelet Disord. 2022;23(1):167.
Faust KC, Kimbrough T, Oakes JE, Edmunds JO, Faust DC. Polydactyly of the hand. Am J Orthop (Belle Mead NJ). 2015;44(5):E127-34.
Blauth W, Olason AT. Classification of polydactyly of the hands and feet. Arch Orthop Trauma Surg. 1988;107(6):334-44.
Bubshait DK. A review of polydactyly and its inheritance: connecting the dots. Medicine (Baltimore). 2022;101(50):e32060.
Satake H, Ogino T, Takahara M, Kikuchi N, Muramatsu I, Muragaki Y, et al. Occurrence of central polydactyly, syndactyly, and cleft hand in a single family: report of five hands in three cases. J Hand Surg Am. 2009;34(9):1700-3.
Naruse T, Takahara M, Takagi M, Ogino T. Early morphological changes leading to central polydactyly, syndactyly, and central deficiencies: an experimental study in rats. J Hand Surg Am. 2007;32(9):1413-7.
Manske PR. Cleft hand and central polydactyly in identical twins: a case report. J Hand Surg Am. 1983;8(6):906-8.
Wall LB, Bae DS, Oishi SN, Calfee RP, Goldfarb CA. Synpolydactyly of the hand: a radiographic classification. J Hand Surg Eur Vol. 2016;41(3):301-7.
Alzarmah I, Bhat TA, Nawwab E. Complex hand polydactyly: a case report and literature review. Cureus. 2021;13(12):e20856.