Presence of extra digits on the little finger side is also known as post axial polydactyly. The extra finger can be fully formed and deformed interfering with the hand function. It can be floppy and can get twisted around its thin stalk. This condition can be a part of numerous syndromes.
The condition is strongly associated with genetic inheritance patterns when it is isolated and non-syndromic.
The extra digit can interfere with daily activities like coming in the way of putting the hand in the pocket or can get hit somewhere. The floating type can get painful or infected when it gets twisted on itself.
Initial treatment locally by ligating the pedicle using hair or ligatures can lead to infection and non-healing of the wound. Often babies are bought to us with incessant crying due to an infected extra finger treated with home remedies. The ligation can lead to painful neuroma which is a swelling of the nerve end that is cut by the ligation.
Treatment by a trained surgeon is needed to plan the incisions and remove the extra finger without bad scarring. If the base of the digit is broad, removal along with plastic and reconstructive surgery may be needed. If both the hands are affected, we can remove both the extra fingers in one sitting.
Post-operatively, the hand will be immobilised in a soft bulky dressing or an above elbow Plaster of Paris slab. The child can go home on day 3 or 4 of surgery. The dressing will be changed under anesthesia, at one week from the date of surgery. The stitches are absorbable and dressings can be removed after a week for washing.
