– deformation of a limb, characterized by the presence of additional fingers on the hands or feet. With polydactyly, the child has additional normally developed fingers or their vestigial appendages on the arms or legs; syndactyly and brachydactyly often occur. Diagnosis of polydactyly is based on a visual examination of the limb, X-ray data of the bones and fingers of the hand/toe, and the results of genetic counseling. Treatment for polydactyly involves surgical removal of the extra digits, using skin, tendon, or bone grafting if necessary.

ICD-10

Q69

General information

Polydactyly is an anatomical anomaly representing a congenital increase in the number of fingers or toes from six-fingered to multi-fingered. Information about the frequency of polydactyly in the population is contradictory: according to different authors, polydactyly occurs in 1 out of 630-3300 newborns; The sex ratio is the same. Polydactyly can appear in its pure form or be combined with other congenital anomalies of the musculoskeletal system - hip dysplasia, brachydactyly, syndactyly, flexion contractures of the fingers, etc.

Polydactyly disrupts the function of the limbs, limits physical development, negatively affects the child’s psyche, is accompanied by the need to wear orthopedic shoes, and limits the choice of profession. The medical solution to the problem of polydactyly is provided by orthopedics and genetics.

Causes of polydactyly

One of the causes of polydactyly is heredity. Familial cases of polydactyly are transmitted in an autosomal dominant manner with incomplete penetrance, i.e. the father or mother are carriers of the polydactyly gene, but they can be healthy. The chance of children inheriting polydactyly is 50%.

In some cases, polydactyly may be one of the symptoms of complex chromosomal disorders (Patau syndrome) and gene syndromes (Meckel syndrome, Ellis-Van Creveld, Lawrence-Moon-Barde-Biedl syndrome, etc.). In genetics, there are about 120 syndromes accompanied by polydactyly.

The causes of isolated polydactyly have not been precisely established. It is assumed that this congenital deformity occurs at 5-8 weeks of embryogenesis and is caused by an increase in the number of mesodermal cells.

Classification of polydactyly

Based on localization, they distinguish between radial (preaxial), central and ulnar (postaxial) polydactyly. With radial localization of the defect, doubling of the segments of the first finger occurs; with the central one - 2-4 fingers; with ulnar – duplication of the 5th finger.

According to the type of duplication, 3 types of polydactyly are distinguished: 1 - the presence of additional vestigial fingers consisting of skin; 2 – the presence of additional fingers, which are a bifurcation of the main ones; 3 – the presence of full, normal shape and size of additional fingers. An important classification feature is the presence or absence of deformation of the main finger in polydactyly, since surgical tactics will depend on this.

Polydactyly is most often found on the hands, although an increase in the number of toes is possible, as well as a combination of polydactyly on the hands and feet. According to observations, unilateral polydactyly predominates over bilateral (65% and 35%, respectively); right-sided - approximately 2 times higher than left-sided.

Symptoms of polydactyly

The main sign of polydactyly is the presence of extra fingers on the hands or feet. In this case, additional fingers can be of normal size and structure or represent rudimentary appendages. In most cases, the accessory fingers are small in size and have a reduced number of phalanges; They are often completely devoid of a bone base and represent non-functioning soft tissue formations on a skin stalk. Sometimes doubling of only the nail phalanx occurs.

In addition to an increase in the number of fingers, with polydactyly there is deformation of the osteoarticular apparatus of the affected segments, which progresses with age and contributes to the development of secondary deformations and static-dynamic disorders.

With chondroectodermal dysplasia (Ellis-Van Creveld syndrome), polydactyly is combined with symmetrical shortening of the limbs, short stature, chest deformation, congenital heart defects (atrial septal defect, single atrium, ventricular septal defect, aortic stenosis), clubfoot, etc.

In the structure of Lawrence-Bardet-Moon-Biedl syndrome, along with polydactyly, mental retardation, obesity, retinitis pigmentosa, underdevelopment of sexual characteristics, syndactyly, and cranial deformation are noted.

Children with Patau syndrome (trisomy 13) have multiple developmental defects: microcephaly, myelomeningocele, microphthalmia, corneal opacity, ear deformation, cleft lip and palate, polydactyly, oligophrenia, defects of internal organs (heart, blood vessels, spleen, pancreas) , kidney).

Diagnosis of polydactyly

Diagnosis of polydactyly is carried out on the basis of clinical, radiological, electrophysiological, biomechanical, genetic and other research methods.

Clinical diagnosis of polydactyly involves examining the child by a pediatric orthopedic traumatologist, identifying anatomical and functional disorders, and determining the type of deformity. In addition to an orthopedist, a child with polydactyly should be examined by a medical geneticist and a pediatrician.

An X-ray examination consists of performing an X-ray of the hand or X-ray of the foot and assessing the anatomical relationships of the osteoarticular apparatus. To identify and assess the condition of bone, cartilage and soft tissue structures, MRI of the hand or foot is indicated.

Of additional importance in the examination are electrophysiological diagnostic methods (electromyography, rheovasography), which make it possible to determine the condition of the muscles and regional blood flow in polydactyly. Biomechanical studies (stabilography, podography) are aimed at determining the static load on the limbs with polydactyly foot.

Genetic diagnostics includes genealogical analysis, establishing the type of inheritance, predicting the risk of having a child with polydactyly in a given family. For polydactyly associated with chromosomal and gene syndromes, prenatal diagnosis (obstetric ultrasound, amniocentesis or chorionic villus biopsy with fetal karyotyping) is of particular importance. If the fetus has isolated polydactyly, pregnancy is prolonged; If a severe chromosomal pathology is detected, the question of artificial termination of pregnancy is raised.

Treatment of polydactyly

Polydactyly is treated only surgically. If the additional finger is connected to the main one only with the help of a skin membrane, its removal is carried out in the first months of the child’s life. In all other cases, it is advisable to postpone surgical intervention until the age of 1 year.

Options for surgical correction of polydactyly, depending on the type of deformity, can be different: removal of an additional segment (finger) without surgery on the main finger; removal of an additional segment (finger) with corrective osteotomy of the main finger; removal of an additional segment (finger) with skin, tendon or bone grafting.

Rehabilitation activities in the postoperative period include exercise therapy, physiotherapeutic procedures (magnetic therapy, infrared irradiation), massage.

Forecast and prevention of polydactyly

Isolated polydactyly in most cases can be successfully cured surgically. The best functional and cosmetic results are achieved when surgery is performed at an early age. In polydactyly associated with genetic or chromosomal abnormalities, the prognosis is determined by the severity of the underlying syndrome.

Prevention of polydactyly involves medical and genetic counseling of couples whose families have inherited cases of polydactyly; careful pregnancy planning and exclusion of any possible adverse effects in the first trimester of fetal development. Prevention of postoperative relapses and complications consists in choosing the optimal method of surgical correction and carrying out full rehabilitation. After surgery, children should be monitored by a pediatric orthopedist until the end of the period of intensive growth of the hand and foot (14-15 years).

Congenital anatomical abnormalities of the fingers; in medical practice, such a pathology is extremely rare and is called polydactyly. Statistics indicate that 1 in 5 thousand babies are born with 6 fingers. In this case, after diagnosis and necessary research, surgical removal of the extra finger is performed.

Features and causes of pathology

Modern medicine knows several forms of polydactyly, but the most common localization of the appearance of an additional limb is the area of ​​the little finger and thumb. It is characteristic that an additional (6) finger can appear on one limb or on both.

There are several causes of polydactyly:

• geneticists claim that the formation of extra fingers occurs from 5 to 8 weeks of pregnancy, when an increase in mesodermal cells is observed;
• There is another theory about six-fingeredness as a result of the bad habits of the mother during pregnancy, especially smoking. In addition, such anomalies can be provoked by severe stress in the first 3 months of pregnancy, at the stage of formation of fetal organs and systems;
• Polydactyly is possible with Patau syndrome (trisomy), in which one extra chromosome is determined in the human genome. In this case, there is a violation of the development of all organs;
• Rubinstein-Taybi syndrome is also accompanied by similar finger anomalies. In this case, the patient experiences deformation of the craniofacial bones and duplication of the fingers or their terminal phalanges;
• extremely rarely, the cause of six-fingeredness can be a genetic disease classified as Smith-Lemli-Opitz syndrome, in which serious pathologies of the endocrine system are observed.

In addition, each type of polydactyly has certain pathological features, for example, in some cases the finger does not have a bone base and hangs on a thin strip of skin. In this case, the tumor is removed painlessly for the baby in the maternity hospital. However, in cases where bone formation is present, more serious surgical intervention and a number of preliminary diagnostic measures are required.

Polydactyly in children

In children, there are several forms of polydactyly (preaxial and postaxial), directly dependent on the location of the tumor. With postaxial, the sixth finger is located behind the little finger, while with preaxial, it is in front of the little finger. If the extra finger on the hand is sufficiently well developed and connected to the 5th metacarpal bone, we can talk about hereditary transmission of the anomaly.

Preaxial polydactyly

Pathological growths in the foot area are often encountered in childhood. In this case, the pathology is characterized by an increase in the number of fingers, metatarsal bones or phalanges. This condition may be accompanied by deformation of the joint, bones and tendon ligaments. The greatest progression is observed when the baby is actively growing, which significantly complicates further treatment and increases the rehabilitation period.

As a rule, an abnormal neoplasm is determined visually by a pediatrician or neonatologist immediately after the birth of the baby, however, removal of a toe or hand requires additional examination, which includes:

• clarification of localization (preaxial or postaxial);
• the nature of the pathological formation (with hereditary transmission, the additional finger is quite well developed, in contrast to a congenital defect, when the finger is formed in the form of 1 or several intradermal protrusions);
• the presence of additional anatomical disorders and deformations in the joint area;
• To determine the independence of the anomaly, all characteristic signs are assessed.

At the final stage, the doctor selects the necessary treatment tactics, which includes not only excision of the extra finger, but rehabilitation care for the children, providing fairly good care, and, if necessary, further plastic surgery.

It should be borne in mind that in the absence of timely medical intervention, children may seriously suffer from mental health, manifested by an inferiority complex and limited physical development.

Preoperative diagnosis

As a rule, removal of the 6th finger is performed at an early age, which is due to the elasticity of the bone tissue and the possibility of rapid remodeling and regeneration. In addition, in childhood, blood circulation and neuromuscular functions are restored quite well.

For all types of polydactyly, a preliminary x-ray examination is used to more accurately determine the characteristic changes in bone tissue and various options for connecting the sixth finger with the phalanges

In addition to radiography, the traditional method of determining the risks of circulatory problems during surgery is used. To do this, a tourniquet is applied to the base of the excised finger for a few seconds. If there is a sharp blanching of the main finger, which does not disappear for a long time, it means that these areas are connected by common blood vessels.

Sometimes an extra toe on the feet or hands can indicate serious pathological disorders in the baby’s body, so mandatory examination and preparatory measures are required before the operation. This is important because the characteristics of the course and development of the pathology directly affect the amount of surgical intervention required.

Removing a skin fold supplied by capillaries is quite simple, but in cases where all fingers, including the sixth, are accompanied by similar symptoms, repeated operations may be necessary.

In adult patients, there are cases of blood supply to the vessel of 2 partially separated fingers at once, so surgeons recommend excision of neoplasms in the first 2-3 months of the baby’s life, while the bone tissue is not yet sufficiently formed. In especially severe cases, as well as when maintaining full functionality of all fingers, the doctor may decide that surgical intervention is inappropriate.

In most cases, taking into account the results of preliminary diagnosis and the general condition of the patient's severity, the outcome of surgical intervention is favorable.

The choice of method for removing polydactyly is based on several factors: congenital defect of the foot or hand, the age category of the patient and concomitant pathological disorders in the fingers or metatarsus.

The operation is performed under completely sterile conditions by specialists with extensive practical experience in surgery.

In complicated forms of polydactyly, not only removal of the extra finger is required, but also further reconstruction with subsequent restoration of the tendon-muscular and osteoarticular apparatus. In addition, if the operation is untimely, secondary deformations may develop, which provides for a number of associated complications.

During foot surgery, the extra toe can be removed in the central part (from the inner or outer edge). Such anomalies involve the removal or excision of the 7th and 2nd rays on the foot if there are protrusions of the sphenoid bone and cuboid edge on it.

To perform this type of operation, no lengthy preparation is required; standard diagnostics and laboratory results are sufficient.

As a rule, operations are scheduled for the first half of the day, since 6 hours before the procedure a person should not drink or eat, which is due to the use of anesthesia during the operation. The duration of the procedure is from 45 minutes to 1 hour. After removing the extra finger, the surgeon fixes the operated limb using a special knitting needle, followed by applying a plaster cast.

It should be borne in mind that any surgical intervention is permissible only against the background of the patient’s absolute health. Even the slightest signs of acute respiratory viral infection (mild malaise and coughing) are a contraindication for the procedure, since there is a high risk of postoperative complications.

Postoperative wound for removing an extra finger

Rehabilitation period

Hospitalization of the patient involves his stay under the supervision of doctors for at least 14-15 days with periodic dressings of the operated area (once every 2 days). In addition, a number of physiotherapeutic measures are prescribed to relieve swelling, hematoma and accelerate the regeneration of damaged tissues.

After 1 month, the wire and plaster are removed, the doctor prescribes a control x-ray examination to confirm the integrity of the bone tissue and the formation of callus. Next, a visit to a specialist is scheduled 1-2 times during the first month after discharge from the hospital. This is necessary so that the surgeon can promptly identify the possible formation of scar tissue in a newborn baby and prescribe appropriate treatment (gymnastics, ointments, gels, etc.)

In most cases, the operation and rehabilitation period proceed well, however, the older the patient’s age, the higher the percentage of various types of complications and the longer the rehabilitation period. All patients with congenital anomalies, including six-fingered teeth, are subject to mandatory dispensary observation. It is especially important to monitor the condition of children, as their bones continue to grow. With timely assistance, the prognosis for complete restoration of joint functionality and the absence of complications is favorable.

SIX-FINGERS Polydactyly is an anatomical deviation characterized by a greater than normal number of fingers or toes in a person.
One of the reasons for the occurrence of such defects is familial polydactyly (heredity). Polydactyly is most often inherited in an autosomal dominant manner, but sometimes this anatomical deviation is inherited in an autosomal recessive pattern.

According to statistics, one baby out of every 5,000 newborns is born with six fingers. As a rule, the sixth finger is removed immediately surgically. In Russia before the revolution, there were entire villages of six-fingered people. “Six-fingered” is one of Stalin’s nicknames (he had six toes)

Are we alone in the Universe? I think I will not be mistaken if I assume that many people have asked themselves this question at least once in their lives. Without exaggeration, stories about aliens visiting Earth can be called myths of the twentieth century. But do these myths have roots in reality? Is there real proof of the existence of aliens?..

In the famous video “Autopsy of an Alien,” declassified in 1996, it is clearly visible that the number of fingers and toes is six...

Photos of items found after the Roswell UFO crash.
This is what the control panel of the “flying saucer” that crashed in Roswell (USA) in 1947 looked like in the film.

Film “Autopsy of an Alien”

In 1995, an event occurred that changed the entire history of ufology. To this day, the footage presented to the world by Ray Santilli remains a cause of controversy among ufologists and scientists from around the world. And this is not surprising, because the audience was shown an autopsy of a creature that, as Santilli claimed, was not born on our planet.

Amazing footage

Having watched the film, or at least its fragments, which depict the creature, it is difficult not to believe Santilli. At the very least, we have to admit that the autopsy shown is not of a person. Unfortunately, the filming quality is far from ideal, however, a lot can be said about the creature.

It is about 140 centimeters tall, without hair and sexual characteristics. As far as the black and white recording can tell, the creature has pale skin, a disproportionately large head with a small flat nose and small ears, and, again, disproportionately large dark eyes. The mouth is slightly open, but no teeth are visible. The creature has six fingers and toes. And, very strangely, there is no navel. http://www.mirf.ru/Articles/print46.html

It’s interesting: in 1947, a Pierre Gandon stamp was issued in Monaco with the six-fingered late US President and philatelist during his lifetime, Franklin Roosevelt, in a series dedicated to the philatelic exhibition in New York. And in the same year, Roosevelt’s country was allegedly visited by real six-fingered aliens and fell into the clutches of Roosevelt’s five-fingered compatriots.

The truth is somewhere near. Gdynia incident

"...The face of this creature, similar to a small man, was badly burned. His body was tightly fitted with a jumpsuit, reminiscent of a scuba diver's wetsuit, only made of some kind of heavy-duty metal-containing material.
The mysterious creature was taken to the clinic of the University of Gdansk, or, according to other sources, Gdynia itself. There he was examined, first of all paying attention to the unusual hands, which had six fingers. It would be appropriate to recall here that the aliens from the UFO that crashed in 1947 near Roswell, USA, had the same hands. The feet of the Gdynia newcomer also turned out to have six toes. It was possible to undress the humanoid only with the help of special tools. When the bracelet, which hardly served as an ornament, was removed from the creature’s hand, his health began to deteriorate sharply. A couple of days later the little man died. Either due to severe internal injuries received during the fall and a complete loss of strength, or due to the fact that the bracelet was removed from his hand.
De Vincent-Martin claims that the remains of the mysterious creature, under heavy security, were sent to the Soviet Union and there subjected to careful and comprehensive research, the results of which are still classified."
http://ufoinspace.ru/articles.php?id=148

“They lived in caves and came from the sky,” Athaide Ferreira da Silva Netto, president of the Ufological Association of the state, quotes local legends. Other legends tell of a certain column of fire that came from heaven. Having taught the Indians some “sciences”, the dwarfs again went to their world.

Sheaves of light sank into the lake and then sank high into the sky - the Indians passed this legend on from generation to generation. Traces found in caves in a remote region of Brazil strangely confirm the legend of six-fingered, short aliens.

Another legend of the Xavantes Indian tribe says that once Lake Encantada, located in the municipality of Nova Xavantina, was the gateway to the home of the gods. According to legend, sheaves of light sank into the lake and then flew into space. Indians are still afraid to swim there, believing that some unknown force will take them with them, writes the Brazilian Terra.

The Indians of the Bororos and Xavantes tribes, living in the Brazilian state of Mato Grosso, tell legends about small aliens about 1.2 m tall.

The Mystery of the Little Feet Cave

After the arriving “Lilliputians” taught the Indians some “sciences,” they again went to their world.” Indeed, in the Blue Mountains National Park in the municipality of Barra do Graças, Mato Grosso state, there is a cave that bears the name “Cave of Little Feet” because clear imprints of small six-toed feet are visible all over the surface of the grotto - on the floor, walls and ceiling.

Have you ever heard of people with “extra” fingers? Or maybe you saw them? Notes on children and adults who have six fingers or toes appear quite often. The Internet is replete with photographs of people with unusual limbs, and ordinary people tend to classify such a feature as a deformity or disease. Whether this congenital defect is so terrible can be understood only by learning the reasons for the appearance of extra fingers.

Polydactyly is the name given to a congenital anatomical anomaly that manifests itself as extra fingers on the feet or hands. Statistics say that out of every five thousand newborns, one has a deviation in the number of fingers, and this defect does not always manifest itself symmetrically.

Varieties of polydactyly

Congenital changes with this developmental anomaly can manifest themselves in several ways:

1. If the bifurcation of the rudimentary structures of the phalanges occurs in the early stages of development, a full-sized and fully functional additional finger is formed.
2. The appearance of rudimentary undeveloped processes on the outer or inner edge of the palm and foot.
3. The bifurcation or appearance of processes on the fingers is also referred to as the phenomenon of polydactyly.

The situation when a person has fully functional six fingers on his hand (photo below) is rare. In India, such children are born more often than in other regions, so this sign is included as a separate item in police questionnaires. As a rule, the accessory phalanges cannot be operated on or even controlled in any way, and people with six fingers undergo corrective surgery.

Causes of polydactylism

The teratogenic effect of chemicals on the fetus (taking certain medications by a pregnant woman) can cause a disruption in the order of cell division and the formation of tissues and organs. In the case of congenital polydactyly, the rudiments of the digital phalanges are exposed to toxins.

The heredity factor, according to doctors, is the main reason for the appearance of extra fingers. Often in a family pedigree one can trace the inheritance of a given defect and its appearance through a generation or in a series of several generations in a row. The genes that cause polydactyly are dominant, which means they appear when they are present in the genotype. But it happens that due to incomplete penetrance, the defect still remains hidden.

Isolated polydactyly does not pose additional threats to the body, but polydactyly often manifests itself as part of complex gene or chromosomal disorders. Scientists know up to 120 syndromes, the sign of which is six fingers or more (Patau, Lawrence, Meckel syndromes).

Diagnosis of polydactyly in newborns

Immediately after birth, the baby is examined by a pediatrician or neonatologist. Therefore, when a child is born with six fingers or toes, the diagnosis is made immediately.

To determine treatment methods, the doctor needs to establish:

1. The position of the additional finger of the hand, which can be preaxial (between the ring finger and little finger) or postaxial - behind the little finger.
2. Nature of the pathology. With hereditary polydactyly, the accessory digit extends from the fifth and is quite well developed. If we are talking about a congenital defect, then the finger will be underdeveloped, in the form of one or several phalanges inside a skin protrusion.
3. The presence of additional changes in the anatomy of the metacarpus or metatarsus, which may manifest itself in the form of additional bones, deformities of the joints, ligaments and tendons.
4. Is polydactyly an independent anomaly or manifested itself as part of a syndrome. To do this, other symptoms are assessed and additional tests are ordered.

After this, a treatment method is selected. It involves the surgical removal of extra toes so that a child who has six toes or a deformed foot from birth can develop normally without feeling psychologically or physically impaired. The doctor determines at what age it is best to remove it, and whether plastic surgery will be needed to restore the aesthetic appearance of the limb.

Preparing for surgery

Features of the genesis of polydactyly affect the extent of surgical intervention. For example, a skin fold that is supplied by capillaries is easy to remove. And if six fingers on the hands are accompanied by corresponding changes in the metacarpus, then more than one operation will be required. And in cases where the “extra” fingers are fully functional, a decision may be made to leave everything as is.

When choosing a method for surgical treatment of polydactyly, doctors conduct several more studies:

• radiography of the limb;
• study of the blood supply to the accessory fingers.

There are cases when a large vessel feeds two partially separated fingers at once. Then removal without taking this feature into account can lead to subsequent blood supply disturbances.

When all studies are completed, surgery is performed. Sometimes it is preceded by therapeutic treatment, but such cases are rare. Usually the attending physician insists on treating polydactyly at an early age; most operations are performed in the first month of the child’s life.

Delay only complicates the situation, because the bones and surrounding tissues in children grow quickly and experience a certain load. The earlier the plastic surgery is done, the fewer secondary deformations you will have to deal with.

What if you leave...

On the hands, especially if all the fingers are well developed and the hands are symmetrical, this feature will do little to hinder. Unless you have to order gloves from a tailor and catch curious glances.