Last revised by Dr Rohit Sharma on 09 Jan 2022

Polydactyly (less commonly called hyperdactyly) refers to the situation where there are more than the usual number of digits (five) in a hand or foot. It can be broadly classified as:

Estimated incidence is different for pre and postaxial polydactyly 6:

  • postaxial: ~1 in 3000
  • preaxial: ~1 in 7000

Central polydactyly is the rarest encountered.

In addition, there may be a greater prevalence in individuals of African descent (particularly for postaxial polydactyly) 7.

A large proportion of polydactyly is isolated although they can be associated with an immense amount of anomalies which include:

Other than describing polydactyly based on the position of the accessory digit, it can also be described by the number of total digits e.g. hexadactyly (six digits), or even, heptadactyly (seven digits). Indeed the presence of seven individual digits is exceedingly rare but has been reported twice 8.

Whilst radiology has little role in the diagnosis of polydactyly it is important in two ways:

  1. assessment of the remainder of the skeleton (if appropriate) for other skeletal anomalies, and as such aiding in the diagnosis on an underlying syndrome (which in turn may point to additional unsuspected anomalies, and allow for genetic counseling etc.)
  2. assess the local anatomy to aid in surgical planning. Of particular importance is the anatomy of the 'normal' digits and the relationship of the extra digit to the adjacent bones and joints.

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 dependent on the rest of the syndrome.

The term "polydactyly" is derived from the Greek words "πολύς - polus" (many) and "δάκτυλος - daktulos" (finger).

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Cases and figures

  • Case 1: post axial
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  • Case 2: with tibial hemimelia
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  • Case 3: pre axial
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  •  Case 4: ulnar dimelia
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  • Case 5: with Ellis-Van Creveld syndrome
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  • Case 6: antenatal ultrasound with trisomy 13
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  • Case 7: antenal ultrasound
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  • Case 8: pedal post-axial
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  • Case 9: Pallister-Hall syndrome
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  • Case 10: post-axial polydactyly
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  • Case 11: postaxial polydactyly of the foot
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  • Case 12: postaxial polydactyly
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