Condition
Polydactyly
This condition has the following symptoms:
Extra fingersExtra toesHand function limitsShoe-fitting troubleWalking discomfortPolydactyly means being born with extra fingers or toes. It is a genetic/congenital condition and the features are present at birth and lifelong. Many people with polydactyly have no pain, but some notice trouble fitting shoes, grip changes, or rubbing and skin irritation. Treatment often involves observation or simple surgery in infancy or childhood, and most people do very well. Polydactyly does not affect life expectancy, and family patterns can vary by type and ancestry.
Short Overview
Symptoms
Polydactyly features one or more extra fingers or toes, ranging from a small skin tag to a fully formed digit. It’s usually spotted on prenatal ultrasound or at birth, on one or both hands/feet. Some notice grip or shoe-fit challenges.
Outlook and Prognosis
Most people with polydactyly do well, especially when the extra finger or toe is corrected in early childhood. Hand or foot function is usually strong, and long‑term pain is uncommon. If polydactyly occurs with a genetic syndrome, outlook depends on that condition’s course.
Causes and Risk Factors
Polydactyly usually stems from genetic changes during early limb development, often inherited and sometimes part of a genetic syndrome. Risk is higher with a family history or certain ancestries. It begins before birth and isn’t driven by lifestyle or environment.
Genetic influences
Genetics play a major role in polydactyly. Most cases are inherited in an autosomal dominant pattern, though new (de novo) variants can occur. Sometimes polydactyly appears alone; other times it’s part of a genetic syndrome, so family history and evaluation matter.
Diagnosis
Polydactyly is usually diagnosed at birth by seeing extra fingers or toes. X-rays define bone and joint involvement, guiding treatment. When features suggest a syndrome or family pattern, genetic tests support the genetic diagnosis of Polydactyly.
Treatment and Drugs
Treatment for polydactyly depends on the finger or toe’s size, position, and how it affects function or shoes. Options range from tying off tiny, skin-only digits in infancy to surgical removal and reconstruction, often by a hand or foot specialist. Pain control, splints, and therapy support healing and fine motor skills.
Symptoms
In daily life, extra fingers or toes can change how gloves fit, how shoes feel, or how a child holds a toy. The early features of polydactyly are usually noticed at birth, and sometimes even before birth on ultrasound. Extra digits can be small and soft or fully formed and functional. Features vary by person and may be present on one side or both.
Extra fingers: One or more extra fingers can appear on one or both hands. They may sit next to the thumb or little finger, and less often in the middle. This can change how a child grasps or how tools feel.
Extra toes: Extra toes can occur on one or both feet. They often make snug shoes uncomfortable or cause rubbing between toes. Balance and walking are usually normal.
Small nub or full digit: The extra part can be a soft bump made of skin and tissue, or a fully formed finger or toe with bone and a joint. Smaller nubs can snag on clothing, while fully formed digits may move or have sensation. Doctors consider structure when planning care.
Has a nail: The extra digit may have its own nail, or the nail may be very small or absent. A well-formed nail often means the digit is more developed. This detail can guide decisions about removal or reconstruction.
Location pattern: Clinicians call this preaxial, postaxial, or central, which means the extra digit is near the thumb/big toe, the little finger/little toe, or the middle digits. Most people with polydactyly have the extra part on the little finger or little toe side. The exact spot helps predict function and treatment options.
One or both sides: Polydactyly may affect just one hand or foot, or both. One side can look different from the other. The number and size of extra digits can vary even within the same person.
Grip or dexterity: In the hand, an extra digit can change how the thumb and fingers work together. Some may find fine tasks like buttoning or typing feel awkward. Others notice no functional limits.
Shoe fit problems: On the foot, extra width can create pressure points in standard shoes. This may lead to rubbing, blisters, or calluses. Wider or softer footwear can help until care is decided.
Pain or irritation: Most people do not have constant pain from polydactyly. Irritation can happen if the extra digit twists, catches, or gets bumped. Tenderness is more likely with tight footwear or during sports.
Appearance concerns: The look of an extra finger or toe can draw attention or questions. Some children and adults feel self-conscious, especially with open shoes or gloves. Supportive conversations and thoughtful wardrobe choices can make daily life easier.
Other hand-foot differences: Extra digits can occur with joined digits or curved fingers or toes. These combinations can affect alignment or movement. Your clinician will check for these during an exam.
Family pattern: Polydactyly often runs in families and can be inherited. The pattern can vary widely, even among relatives. Genetic counseling may help if you’re planning a pregnancy or have questions about recurrence.
Before birth findings: Many cases of polydactyly are seen on prenatal ultrasound. Imaging can show location and size, but the full structure is confirmed after birth. Newborn exams help plan next steps.
How people usually first notice
Many people first notice polydactyly at birth when a newborn has an extra finger or toe, which may be fully formed with bone and nail or a small soft tissue nub connected by a thin stalk. Sometimes the “first signs of polydactyly” show up on a routine prenatal ultrasound, where the sonographer counts more than five digits on a hand or foot. In families with a known history, parents and doctors may be watching closely, but for many, the extra digit is an unexpected finding during the first newborn exam.
Dr. Wallerstorfer
Types of Polydactyly
Polydactyly has a few well-recognized types based on where the extra finger or toe forms and how it is connected. These types matter because they can change day-to-day function, like how a shoe fits or how easily a child grasps a toy. Clinicians often describe them in these categories: preaxial, postaxial, and central, with some rare genetic syndromes including specific patterns. Knowing the main types of polydactyly can help you understand the likely symptoms and what surgery or monitoring might involve when exploring types of polydactyly.
Preaxial (thumb/big toe)
The extra digit is on the thumb or big-toe side and can range from a small split tip to a full extra digit. Hand function and pinch strength may be affected if bones or tendons are shared.
Postaxial (little side)
The extra digit is on the little finger or little-toe side and may be a soft tissue nub or a well-formed finger or toe. Shoes may rub or cause calluses if the toe is prominent.
Central (middle digits)
The extra digit appears among the middle fingers or toes and is less common than the other types. It often comes with differences in bones or joints that can influence grip or how the foot bears weight.
Syndromic patterns
Some people have polydactyly as part of a genetic syndrome, which can include other features beyond the hands or feet. In these cases, specialists may recommend genetic testing and coordinated care.
Did you know?
Extra fingers or toes can look different depending on the gene involved: GLI3 changes often cause well-formed extra digits, while ZRS/SHH changes more often create small, skin-only nubbins. Certain variants also cluster by location—preaxial (thumb/big toe) vs postaxial (little finger/toe).
Dr. Wallerstorfer
Causes and Risk Factors
Polydactyly usually starts with a change in the genes that guide hand and foot growth before birth. Some risks are written in our DNA, passed down through families. It can also occur with certain chromosome differences or genetic syndromes. Risk factors for polydactyly include a family history and higher rates in some populations. Some prenatal exposures or medical conditions in pregnancy may raise risk, but most daily habits do not.
Environmental and Biological Risk Factors
Some pregnancies carry body-based or environmental factors that can raise the chance of Polydactyly. Doctors often group risks into internal (biological) and external (environmental). This section highlights biological and environmental risk factors for Polydactyly that research has linked to a higher chance of this limb difference.
Advanced maternal age: Older egg biology can slightly increase the chance of limb development differences. The overall risk remains low for any single pregnancy.
Advanced paternal age: Biological changes that come with older sperm age may raise the chance of new developmental differences. For most families the increase in risk is small.
Maternal diabetes: Preexisting, poorly controlled diabetes around conception and in the first trimester can disrupt early limb formation, sometimes including Polydactyly. Better glucose control before and early in pregnancy lowers this risk.
Early teratogen exposure: Certain agents taken early in pregnancy—such as retinoic acid medicines (like isotretinoin) or very high-dose vitamin A—can alter limb patterning, occasionally including Polydactyly. These exposures are most concerning in the first 8–10 weeks of pregnancy.
Genetic Risk Factors
In many families, extra fingers or toes run strongly due to changes in genes that guide limb formation. The most common genetic causes of polydactyly range from single‑gene variants to chromosomal differences. People with the same change can show different features, from a small nub to a fully formed digit. Even strong risks don’t guarantee a specific outcome.
Family history: If a parent has polydactyly from a single‑gene cause, each child has about a 50% chance of inheriting it. Expression can differ widely among relatives.
Recessive inheritance: When both parents carry the same hidden change, a child can inherit polydactyly even if neither parent has extra digits. In this pattern, each pregnancy has a 25% chance of being affected. This is more common in some syndromic forms.
De novo variants: A new change can appear for the first time in a child with polydactyly, with no prior family history. Recurrence risk is usually low, though a small chance remains if a parent has germline mosaicism.
GLI3 gene changes: Variants in GLI3 are a well-known cause of isolated polydactyly and related patterns. Depending on the variant, the change can also be linked with conditions such as Greig or Pallister‑Hall syndromes.
SHH regulatory changes: Alterations in a control region that turns the SHH limb signal up or down often cause thumb or big‑toe duplication. These changes commonly underlie familial preaxial polydactyly.
Syndromic forms: Polydactyly can occur as part of broader genetic syndromes like Bardet–Biedl or Ellis–van Creveld. In these cases, other features point to the diagnosis and guide gene testing.
Chromosomal differences: Having extra or missing chromosome material, especially trisomy 13, can include polydactyly among its findings. Smaller microdeletions or duplications near limb‑patterning genes can have similar effects.
Ancestry patterns: Postaxial polydactyly is more frequent in people with West African ancestry due to variants that are more common in those populations. Rates are lower in many European and East Asian groups.
Variable expression: The same genetic change can range from a tiny skin tag to a fully formed extra finger or toe. Sometimes a carrier shows no visible difference at all.
Parental relatedness: When parents are biologically related, they are more likely to share the same rare recessive change. This raises the chance of recessive syndromes that include polydactyly.
Dr. Wallerstorfer
Lifestyle Risk Factors
Polydactyly is a congenital difference; lifestyle habits do not cause it. However, day-to-day choices can influence comfort, function, and the risk of skin or overuse problems. In practice, how lifestyle affects Polydactyly is mainly about pressure management, injury prevention, and postoperative care when surgery is chosen. The elements below focus on pragmatic adjustments tied directly to symptoms and complications.
Footwear choices: Tight or shallow toe boxes can create pressure points on extra toes, causing pain, corns, calluses, or ulcers. Choosing wide, deep shoes with soft uppers and targeted padding reduces friction and skin breakdown.
Repetitive hand tasks: Frequent gripping or tool use can irritate nerves and soft tissues around extra fingers. Ergonomic grips, gloves, and task breaks can lower pain and preserve dexterity.
High-impact sports: Running, jumping, or cleated sports increase shear and stub injuries to extra toes. Low-impact cross-training, proper cushioning, and protective taping can reduce injury risk while maintaining fitness.
Weight management: Higher body weight increases plantar pressure on feet with extra toes, worsening calluses and foot pain. Gradual weight loss can lower pressure and improve walking comfort.
Skin and nail care: Overlapping digits and atypical nail angles can trap moisture and invite fungal or bacterial infections. Regular nail trimming, drying between toes, and antiseptic care help prevent paronychia and athlete’s foot.
Orthotics and padding: Inadequate cushioning concentrates force on prominent digits. Custom orthotics, toe sleeves, or spacers redistribute load and make daily activities more comfortable.
Post-surgery habits: Returning to intense activity too soon after digit removal or reconstruction can impair healing and scarring. Following wound care, splinting, and therapy plans supports better function and appearance.
Instrument and tool fit: Non-optimized instruments or tools can strain extra fingers during work or music performance. Adaptive grips, custom fingerings, or handle modifications reduce overuse and pain.
Exercise selection: Strength and flexibility work can improve gait and hand function, reducing compensatory strain on extra digits. A therapist-guided program targets alignment and protects vulnerable areas.
Risk Prevention
Polydactyly starts before birth, so there’s no way to fully prevent the extra finger or toe from forming. Prevention focuses on understanding family risk, finding it early, and reducing day-to-day problems like rubbing, pain, or injury. Knowing your risks can guide which preventive steps matter most. Planning ahead often makes care simpler and safer for you and your child.
Genetic counseling: Learn how polydactyly can run in families and what your personal risk may be. A counselor can explain chances in future pregnancies and what tests are available.
Preconception options: If risk is high, discuss reproductive choices such as IVF with embryo testing or using donor sperm/eggs. These options have benefits and limits, and a specialist can walk you through them.
Prenatal screening: Ultrasound in early or mid-pregnancy can spot extra digits and check for other differences. This helps plan delivery and newborn care; screenings and check-ups are part of prevention too.
Early specialist referral: Seeing a hand or foot specialist early helps decide if and when removal is needed. Good timing can protect function and reduce scarring or nerve problems.
Safe newborn care: Keep the extra digit clean and dry, and watch for color change, swelling, or tenderness. Avoid string ties or at-home removal to prevent bleeding or infection.
Protective footwear: Choose soft, roomy socks and shoes to avoid rubbing and pressure. Simple padding can reduce trauma and skin irritation.
Injury prevention: Try to prevent catching the extra digit on clothing, toys, or crib bars. Mittens for infants during sleep can lower the chance of snagging.
Syndrome screening: In some families, polydactyly occurs with other health differences. Your pediatrician may check the heart, kidneys, or facial features and offer genetic testing if needed.
Surgery planning: If removal is chosen, discuss the approach, timing, and recovery. Careful planning lowers the risk of pain, infection, or nail problems later.
Emotional support: Normalize differences and answer questions in age-appropriate ways. Caregivers can help by reminding about check-ups and healthy routines.
How effective is prevention?
Polydactyly is a congenital condition, so there’s no way to prevent an extra finger or toe from forming once development begins. “Prevention” focuses on reducing complications, like avoiding problems with shoe fit, skin irritation, or joint pain. Prenatal ultrasound can sometimes detect polydactyly, which helps families plan delivery, specialist evaluation, and timely care. When needed, early treatment—such as surgical removal in infancy—can lower future discomfort and functional issues, but it doesn’t change the chance of polydactyly occurring in future pregnancies.
Dr. Wallerstorfer
Transmission
Polydactyly isn’t contagious—you can’t catch an extra finger or toe from someone else. In many families, it’s passed down in a straightforward way: a change in one copy of a gene from either parent can be enough for a child to be born with it, though the number or placement of extra digits can vary. It can also appear for the first time in a child because of a new gene change (a new mutation), even when no one else in the family has it. If you’re wondering how Polydactyly is inherited, a genetics professional can explain family patterns and the chances in future pregnancies, which may differ if it occurs on its own or as part of another condition.
When to test your genes
Consider genetic testing if you or close relatives have polydactyly, especially when extra digits occur with other differences (heart, kidneys, facial features) that can suggest a genetic syndrome. Test during family planning, pregnancy after an ultrasound finding, or if surgery/care decisions could change with a confirmed gene cause.
Dr. Wallerstorfer
Diagnosis
Polydactyly is usually noticed right away, either on a routine pregnancy scan or at birth when an extra finger or toe is seen. Doctors usually begin with a close physical exam and simple imaging to understand the pattern and how the extra digit is built. The diagnosis of polydactyly is often straightforward at birth, and genetic diagnosis of polydactyly may be suggested if other features point to a broader syndrome. This helps guide care, timing of any procedures, and family planning.
Physical exam: The clinician notes where the extra digit sits (thumb/big-toe side, little-finger side, or middle) and whether it has bone, joints, and a nail. They also check movement, circulation, and skin attachments to plan next steps.
Prenatal ultrasound: A mid-pregnancy scan can show extra fingers or toes and their position. Your provider may suggest a detailed ultrasound to look for other differences that could suggest a syndrome.
X-ray imaging: Hand or foot X-rays show whether the extra digit has full bones and joints or is attached by soft tissue. These images help distinguish the type of polydactyly and guide surgical planning if needed.
Genetic testing: Genetic testing may be offered to clarify risk or guide treatment. A small blood sample can check for changes in genes or chromosomes, especially if there are other health findings or a family history.
Family history: Family history is often a key part of the diagnostic conversation. Learning who else has extra digits and how they were affected can point to inherited patterns and help estimate recurrence risk.
Syndrome screening: Doctors look for other features—such as heart, kidney, vision, or growth differences—that may travel with polydactyly in some syndromes. Finding or ruling out these patterns shapes follow-up and referrals.
Specialist referral: In some cases, specialist referral is the logical next step. A hand or foot surgeon and a genetics specialist can confirm the type, discuss timing of procedures, and coordinate care for associated findings.
Stages of Polydactyly
Polydactyly does not have defined progression stages. It is present from birth—an extra finger or toe—and usually does not change over time, though the size, shape, and attachment of the extra digit can vary. Early signs of polydactyly are often seen on a pregnancy ultrasound or noticed at birth during a routine exam, and X-rays can show how the bones are formed; different tests may be suggested to help confirm the finding and plan care.
Did you know about genetic testing?
Did you know that genetic testing can help explain why polydactyly happens in a family and whether it’s likely to occur again in future pregnancies? Learning which gene change is involved can show if the extra fingers or toes are an isolated finding or part of a broader syndrome, guiding the right checkups and care. With this information, you and your care team can plan treatment, timing of surgery if needed, and make informed reproductive decisions.
Dr. Wallerstorfer
Outlook and Prognosis
Many people ask, “What does this mean for my future?”, especially after a newborn is found to have polydactyly or an adult learns the term for the extra finger or toe they’ve always had. For most people with polydactyly, the long-term outlook is very good. Extra digits on the outside of the hand or foot (postaxial) are especially common and often smaller or loosely attached; they’re frequently treated in infancy with a simple procedure or minor surgery. Central or thumb-side (preaxial) forms can be more complex and may need staged surgery and hand or foot therapy to optimize function, grip, and balance. In medical terms, the long-term outlook is often shaped by both genetics and lifestyle.
Everyone’s journey looks a little different. If polydactyly occurs by itself, life expectancy is normal and most people have typical mobility and use of their hands after treatment. When polydactyly is part of a genetic syndrome (for example, certain ciliopathies), the prognosis depends on the associated features—such as kidney, heart, eye, or breathing issues—and your care team will tailor monitoring and treatments around those risks. Early symptoms of polydactyly that signal a more complex pattern can include limb differences on both sides or other findings at birth; these are cues for a genetics referral and a coordinated plan.
With ongoing care, many people maintain full, active lives, including sports, manual work, and activities that rely on fine motor skills. Surgery aims to create a stable, well-aligned digit and joint; most children and adults achieve good function, though some may need follow-up procedures for alignment, tendon balance, or scar sensitivity as they grow. Complications like stiffness, pain with pressure, or nail deformities can occur but are usually manageable with therapy and, if needed, revision surgery. Genetic testing can sometimes provide more insight into prognosis when doctors suspect a broader condition. Talk with your doctor about what your personal outlook might look like.
Long Term Effects
Most people with polydactyly do well over the long term, especially when the extra finger or toe is small or corrected early. The long-term picture depends on which bones, joints, and tendons were involved and whether surgery was done in childhood. Long-term effects vary widely, from no lasting issues to mild differences in hand use, shoe fit, or sensation. Many refer to the visible extra digit at birth as early symptoms of polydactyly, though this feature is present from day one.
Hand function: Many with polydactyly have normal strength and dexterity over time. Some notice subtle differences with fine motor tasks or grip patterns.
Foot function: Walking, running, and sports are usually unaffected. Some experience pressure points or a different fit in certain shoes due to foot shape.
Appearance differences: Scars or slight asymmetry can remain after removal. Nail shape or contour may differ on the treated finger or toe.
Sensation changes: Areas near the removed digit can feel numb or extra sensitive. This may improve over time but can persist in a small patch.
Joint stiffness: Stiffness or limited motion can occur where bones or joints were involved. For a few, this can affect certain grips or toe push-off.
Tendon and nerve variations: The underlying anatomy may remain atypical even after reconstruction. This can subtly change movement timing or fingertip feedback.
Arthritis risk: If a duplicated joint shared surfaces, there may be a slightly higher chance of early wear in adulthood. Many with polydactyly never develop arthritis in the area.
Growth differences: As children grow, the treated finger or toe may be slightly shorter or curved compared with the other side. Doctors often describe these as long-term effects or chronic outcomes.
Psychosocial impact: Some live with self-consciousness about scars or asymmetry. Even when challenges remain, many people continue full participation at school, work, and social life.
Inheritance considerations: Some families have a higher chance of polydactyly in future children. Genetic testing can sometimes show whether it runs in the family.
Syndromic associations: In a minority, polydactyly occurs with other features as part of a genetic syndrome. Long-term effects depend on the specific condition and extend beyond the hand or foot.
Bilateral differences: One side may look or function differently from the other over time. Doctors may track these changes over years to see how growth affects balance.
How is it to live with Polydactyly?
Living with polydactyly often means small, practical adjustments rather than major limits. Some people have fully formed extra fingers or toes that work well; others have soft tissue “nubbins” or digits that make shoes, gloves, or certain grips awkward, and may choose surgery for comfort, function, or appearance. Day to day, it can draw curious looks or questions, which can be tiring, but many find that a simple, confident explanation helps others adapt quickly. For family and friends, the main effects are offering support with decisions about care—especially in childhood—and staying tuned to what matters most to the person, whether that’s performance, comfort, or self-image.
Dr. Wallerstorfer
Treatment and Drugs
Treatment for polydactyly depends on the finger or toe’s size, position, and how it affects daily use. Some small, soft extra digits can be tied off in infancy, while well-formed extra fingers or toes usually need surgical removal, often in the first year of life to support normal hand or foot function and shoe fit. Doctors sometimes recommend a combination of lifestyle changes and drugs only when there’s pain, swelling, or infection, but most people only need surgery plus wound care, splinting, and hand or foot therapy to fine-tune movement. Not every treatment works the same way for every person, and timing may shift if the extra digit is part of a broader syndrome or if bones, joints, or tendons are involved. Ask your doctor about the best starting point for you, including whether imaging or a genetics referral is helpful before surgery.
Non-Drug Treatment
Extra fingers or toes can affect grip, balance, and how shoes fit day to day. Non-drug treatments often lay the foundation for comfort and function, with surgery considered when the extra digit causes problems. Early symptoms of polydactyly are usually visible at birth, and plans are tailored to the child’s hand or foot shape and family goals. Support for healing and daily activities matters just as much as the procedure itself.
Watchful waiting: If the extra finger or toe is small and painless, doctors may monitor it over time. This approach can be reasonable when polydactyly does not limit function or cause rubbing in shoes.
Surgical removal: Outpatient surgery can remove an extra digit and reshape nearby tissues for better alignment and function. Timing depends on growth, safety, and how much the extra digit affects daily use.
Hand therapy: Gentle exercises help improve range of motion, strength, and coordination. Therapy can start soon after surgery and continues as skills develop.
Footwear and orthotics: Wide, soft-toe shoes and cushioned insoles reduce rubbing and pressure from an extra toe. A podiatrist can suggest padding or custom inserts to improve comfort with polydactyly.
Splints and taping: Short-term splints can support proper positioning after surgery. Taping may help protect tender areas during healing or reduce friction in shoes.
Scar care: Silicone gel, massage, and sun protection can soften scars and reduce sensitivity after removal of an extra digit. These simple steps may improve comfort and appearance over time.
Genetic counseling: A genetics professional can explain how polydactyly sometimes runs in families and discuss testing options if needed. They also review chances of recurrence in future pregnancies and whether other features should be checked.
Imaging and planning: X-rays or ultrasound help map the bones and joints inside an extra finger or toe. This guides whether reconstruction or removal will give the best function.
Psychosocial support: Counseling can help children and families handle questions, teasing, or body-image concerns. Sharing the journey with others can make decisions and recovery feel less isolating.
Activity adjustments: Temporary changes—like avoiding tight footwear, using protective padding, or choosing low-impact play—can prevent pain until treatment is completed. After surgery, gradual return to sports protects healing tissues.
Did you know that drugs are influenced by genes?
Most medicines used around extra digits aren’t about the digits themselves; they’re for anesthesia, pain control, or infection prevention, and responses can vary with your genes. Differences in genes that process drugs can affect dose needs and side‑effect risk.
Dr. Wallerstorfer
Pharmacological Treatments
While polydactyly is typically corrected with minor surgery or suture ligation, medicines support comfort and healing. Drugs that target symptoms directly are called symptomatic treatments. They help with pain control after polydactyly surgery, anesthesia during procedures, and preventing or treating infection. Choices vary by age, the type of extra digit, and whether care happens in the clinic or operating room.
Pain relievers: Acetaminophen (paracetamol) and ibuprofen ease soreness and reduce swelling after removal. In children, doses are weight‑based; avoid exceeding the maximum daily dose. Ibuprofen is best taken with food and should be avoided in some kidney or stomach conditions.
Local anesthetics: Lidocaine numbs the area for suture ligation or clinic removal so the procedure is more comfortable. Longer‑acting options like bupivacaine can extend numbness for a few hours after the visit.
Procedural sedation: Midazolam and fentanyl may be used when a child needs to stay still or for short, uncomfortable steps. These medicines are carefully dosed and monitored to keep breathing and comfort safe during the procedure.
General anesthesia: Sevoflurane and propofol are used in the operating room when bone or joints are involved and full surgery is planned. Anesthesiologists adjust dosing to keep the patient asleep and pain‑free, then help with a smooth wake‑up.
Oral antibiotics: Amoxicillin‑clavulanate or cephalexin are not needed for every case but are used if the wound is contaminated or shows early infection (redness, warmth, pus). Typical courses last several days and should be finished as prescribed.
Topical antibiotics: Bacitracin or mupirocin can be applied as a thin layer to the incision to lower surface bacteria. They are helpful for mild skin irritation without signs of deep infection.
Tetanus updates: Tetanus vaccine or tetanus immune globulin may be given if immunizations aren’t up to date and the wound is at risk. This helps prevent tetanus after accidental contamination.
Opioid rescue: Short courses of combination products like hydrocodone–acetaminophen may be used in adults if pain remains severe despite other options. Use is usually limited to the first 1–2 days due to side effects like drowsiness and constipation.
Genetic Influences
Polydactyly often runs in families because of changes in a single gene that can be passed from parent to child. Even with the same gene change, people can have very different-looking extra fingers or toes, from a small nub to a fully formed digit. Most isolated cases follow an autosomal dominant pattern, meaning if a parent is affected, each child has about a 1 in 2 (50%) chance of inheriting the gene change.
New (de novo) changes also happen, so polydactyly can appear in a family with no prior history. Because the early symptoms of polydactyly are usually visible at birth—or even on prenatal ultrasound—families and doctors can spot patterns early and consider genetic counseling. Sometimes an extra finger or toe is part of a broader genetic syndrome, especially when other features or health issues are present; in those situations, targeted genetic testing can help clarify the cause and the chance of it happening again.
How genes can cause diseases
Humans have more than 20 000 genes, each carrying out one or a few specific functiosn in the body. One gene instructs the body to digest lactose from milk, another tells the body how to build strong bones and another prevents the bodies cells to begin lultiplying uncontrollably and develop into cancer. As all of these genes combined are the building instructions for our body, a defect in one of these genes can have severe health consequences.
Through decades of genetic research, we know the genetic code of any healthy/functional human gene. We have also identified, that in certain positions on a gene, some individuals may have a different genetic letter from the one you have. We call this hotspots “Genetic Variations” or “Variants” in short. In many cases, studies have been able to show, that having the genetic Letter “G” in the position makes you healthy, but heaving the Letter “A” in the same position disrupts the gene function and causes a disease. Genopedia allows you to view these variants in genes and summarizes all that we know from scientific research, which genetic letters (Genotype) have good or bad consequences on your health or on your traits.
Pharmacogenetics — how genetics influence drug effects
Treatment for polydactyly is usually surgical, so the key drug decisions are about anesthesia during the procedure and pain control afterward. Genes can influence how quickly you clear some of these medicines, which can affect both safety and how well they work. For example, genetic differences can make certain opioids such as codeine too weak for pain relief in some people and, rarely, too strong in others, so your team may choose different pain medicines. Variations affecting enzymes that break down a muscle relaxant called succinylcholine can lead to a longer effect, so anesthesiologists avoid it or monitor closely if there’s a known issue. A personal or family history of serious anesthesia reactions, including malignant hyperthermia, should be shared before surgery because it can change the plan. While early symptoms of polydactyly are visible at birth, targeted pharmacogenetic testing is sometimes used when there’s a history of unusual drug responses, helping tailor dosing or drug choice. Your genes are only part of the picture—age, other health conditions, and the details of the operation also guide which medicines and doses are safest.
Interactions with other diseases
When extra fingers or toes occur alongside other health issues, the overall picture can change what follow-up and screening make sense. Doctors call it a “comorbidity” when two conditions occur together. Polydactyly sometimes appears on its own, but it can also be part of broader genetic syndromes—such as Bardet-Biedl, Ellis-van Creveld, or chromosome changes like trisomy 13—that may also involve the heart, kidneys, vision, growth, or learning. Because early signs of polydactyly are visible at birth, it can be a helpful clue to check for related concerns, especially if other features are present. When polydactyly occurs with another illness, one condition can make the other feel harder to manage—for example, differences in the hands or feet may complicate mobility or self-care if there’s also heart or kidney disease. Care is often coordinated across specialties, and genetic counseling may be offered to review family history, discuss future pregnancies, and decide whether any testing would be useful for you or your child.
Special life conditions
Pregnancy can be a time of mixed feelings if polydactyly runs in the family. Ultrasound sometimes spots extra fingers or toes before birth, and doctors may discuss whether anything else is present; most of the time, polydactyly occurs on its own and babies do well. New parents often face practical choices, like whether to remove a small extra digit in infancy or wait until a child is older; timing depends on the digit’s size, bone and tendon involvement, hand or foot function, and family preference.
In childhood, extra digits can affect shoe fit, handwriting, or sports that involve gripping or balance. Occupational or physical therapy may help with fine motor skills, and teachers can make small classroom adaptations. Teens and adults may weigh surgery for functional reasons, comfort in footwear, or appearance; recovery and results are generally good when planned with a hand or foot specialist. For athletes, the focus is on fit and function—custom gloves or footwear and, after any procedure, a graded return to play to protect healing tissues. Not everyone experiences changes the same way, and many people with polydactyly lead active lives without needing surgery.
History
Throughout history, people have described extra fingers or toes in family stories, birth records, and even art. Midwives noted newborns with a small extra digit on the side of the hand; village elders remembered a grandparent with a “double thumb.” These everyday accounts show that polydactyly has long been part of human experience across many regions and cultures.
First described in the medical literature as a visible variation present at birth, early reports focused on what could be seen: where the extra digit sat, how large it was, and whether it could move. Physicians drew careful sketches, distinguishing a small skin tag from a fully formed finger with bone and joints. Surgeons in the 19th and early 20th centuries documented techniques to remove or reshape extra digits, especially when they interfered with grip, walking, or fitting shoes.
As medical science evolved, attention shifted from simple description to pattern recognition. Families and communities once noticed patterns that ran through several generations, and doctors began to record inheritance in family trees. Some families had a history of extra digits on the thumb side of the hand; others had added little fingers or extra toes. These observations hinted at genetic causes long before the genes were known.
In recent decades, knowledge has built on a long tradition of observation. Imaging clarified the bones and joints inside an extra digit, and careful measurements helped guide whether surgery might improve function or comfort. Importantly, clinicians learned that polydactyly can occur on its own or alongside other differences, and that this context directs evaluation and counseling. Not every early description was complete, yet together they built the foundation of today’s knowledge.
With the rise of genetics, researchers connected certain patterns of polydactyly to changes in genes that act like dimmer switches during limb development. This helped explain why the condition varies so widely—from a small, soft nub to a fully formed, working finger. It also showed why two people in the same family can have different presentations.
Today, the history of polydactyly informs practical care. Knowing how surgeons managed it in the past helps set expectations for timing, techniques, and recovery. Recognizing the long record of family patterns supports conversations about inheritance, from the likelihood of passing it on to how early symptoms of polydactyly are identified during pregnancy scans or at birth. Looking back helps explain both the common and the uncommon faces of this condition, and it underscores a central point: treatment choices are guided by function, comfort, and personal preference, shaped by lessons learned over centuries.