Polydactyly

Polydactyly is a congenital condition characterised by the presence of extra fingers or toes, and is one of the most common hand anomalies seen in children. At Olive Skin & Aesthetics, we perform polydactyly correction with the dual goal of achieving a functional, normally appearing hand and ensuring that the child’s grip, pinch strength, and fine motor development are fully preserved or enhanced by the surgery.

The extra digit may be a simple skin tag (rudimentary), a well-formed finger with bones and tendons (fully developed), or a central duplication within the hand. Each type requires a different surgical strategy, and the timing and technique are tailored to the specific anatomy identified on pre-operative X-rays.

• Infants and children with a supernumerary (extra) digit on the hand or foot confirmed clinically and radiologically
• Cases of preaxial (thumb-side), postaxial (little finger-side), or central polydactyly
• Children with associated syndactyly (fused digits) alongside the extra finger — requiring combined correction
• Patients in good general health cleared for general anaesthesia; surgery is typically performed at 9–12 months of age

Surgery is performed under general anaesthesia, typically between 9–12 months of age, though complex central duplications may be deferred until 18–24 months. A detailed pre-operative X-ray assessment determines which digit to preserve and which to remove — the decision is guided by which finger has the best skeletal alignment, tendon attachment, and skin cover.

Simple rudimentary digits are excised at the base. More complex reconstructions involve careful tendon and ligament transfer from the removed digit to reinforce the retained finger, nail plate reconstruction where required, and local flap design to achieve a natural-appearing web space and digit contour. A splint is applied post-operatively for 3–4 weeks.

• Days 1–7: Splint in place. Wound kept dry. Oral analgesia prescribed. Normal feeding and activity for unaffected limbs.
• Week 2–4: Splint removed; wound inspected. Gentle hand activity encouraged.
• Month 1–3: Scar matures. Full range of motion of retained digit monitored. Occupational therapy assessment if indicated.
• Month 3–6: Final functional and cosmetic result assessed. Scar management commenced if needed.