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Figure 1.61. Postaxial Polydactyly is most commonly seen in black infants where it occurs as an autosomal dominant trait. The Polydactyly may be noted as a nubbin of scar tissue, as a pedunculated mass attached by a small pedicle, or as a fully developed digit. Polydactyly may be preaxial, occurring at the thumb or big toe, or postaxial, arising on the ulnar aspect of the fifth finger or fibular aspect of die fifth toe. Central Polydactyly does occur but is extremely rare. The vast majority of infants with Polydactyly have postaxial Polydactyly.

Figure 1.62. Another example of postaxial Polydactyly widi a well-developed digit. These digits may be fairly well formed with one or more rudimentary phalanges. Duplication of digits occurs when one or more extra digital rays are formed during the embryonic period. Polydactyly is an associated finding in many syndromes such as trisomy 13 or 18, Ellis-van Creveld syndrome, Carpenter's syndrome, etc.

Figure 1.63. Bilateral postaxial Polydactyly. Note that Polydactyly may be unilateral or bilateral.

Figure 1.64. Postaxial polydactyly in an infant at birth showing a necrotic, almost amputated, extra digit due to interference with circulation. This would explain why some infants with polydactyly may only have evidence of scarring on the lateral side of the digit.

Figure 1.65. This infant has preaxial polydactyly of the right hand. Preaxial polydactyly is less common but has the same range of severity, with the accessory tissue usually arising from die midportion of the thumb or first toe.

Figure 1.66. In this infant with preaxial Polydactyly, note that the extra digit is poorly developed.

Figure 1.64. Postaxial polydactyly in an infant at birth showing a necrotic, almost amputated, extra digit due to interference with circulation. This would explain why some infants with polydactyly may only have evidence of scarring on the lateral side of the digit.

Microcephalic Newborns

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