Polydactylism

POLYDACTYLISM HORACE Attending

Orthopedic

E.

TURNER,

Surgeon, The American CHICAGO,

is the occurrence of more than the usua1 number of fingers or toes in any animaI, such as pouItry, in cattIe, and in sheep, as we11 as in humans.1-s It is frequentIy associated with syndactylism, which is the occurrence of a web-Iike growth between the fingers or toes. Supernumerary fingers and toes have been observed and numerous articIes written about them but up to date no definite etioIogy has been found. The condition seems to be best expIained upon a hereditary basis in which the dominant MendeIian characteristic is that of poIydactyIism.2J,10.1z In 1866, Lawrence and Moon described a group of patients a11 suffering from simiIar symptoms, and since then such symptoms constitute what is known as a Lawrence-Moon-BiedI syndrome. In 1922 BiedI caIIed attention to the presence of poIydactyIism in many of these cases. In 1929 Harvey G. Beck reviewed 35 reported cases of the Lawrence-Moon-BiedI syndrome, but offered no further information on the poIydactyIia phase. In a series of 64 descendants of an original effected parent, 27 were affected, 33 unaffected, and 4 doubtfu1. l1 This condition is found among the peopIes of practicaIIy every country and is no more prevaIent in maIes than in females. It affects the fingers more frequentIy than the toes. The supernumerary digits are usuaIIy margina1, undeveloped, and Iacking in a corresponding metacarpal bone. The cosmetic effect usuaIIy brings the patient to the doctor, but occasionaIIy the impediment that the supernumerary digit causes whiIe the patient is at work or the diffIcuIty of getting shoes to fit when the afiliction occurs on the foot, is what causes a physician to be consuIted. Many varieties exist, ranging from the simpIe one phaIanx, off-shoot type, to the

P

OLYDACTYLISM

M.D. Hospital of Chicago

ILL.

compIicated osseousIy combined type complicated further by syndactyIism and supernumerary metacarpa1 or metatarsa1, as the case may be.12 The diagnosis is obvious, but before satisfactory treatment may be given, the physician must make a carefu1 roentgenoIogicaI study of the extremity in order to be sure which digit is supernumerary as we11 as to discover any accompanying compIication. Treatment consists of the surgica1 disarticuIation of the extra digit in such a way as to Ieave the Ieast offensive scar from the cosmetic as we11 as the utiIitarian viewpoint. SUMMARY

PoIydactyIism The diagnosis The treatment

is a hereditary is obvious. is surgica1.

condition.

REFERENCES I. VATTI, G. PoIydactyIia-cases in domestic animals. Boll. d. Sot. eustacbiana, 26: 1-20 (March) 1928. 2. GRENE, L. Polydactylia in horses and pigs. Deutscbe Tierarztl. Wcbnscbr., 36: 348 (May rg) 1928. 3. WILSON, H. M. CIydesdale foal’s supernumerary digits. Vet. Rec., 7: 577 (July 2) ,927. 4. BOAS. J. Z. V. PoIvdactvIia in horse. Zool. Jabrb. Ab;. f. Anat., 51: 31&z? (Nov. 6) 1929. 3. KOEHLER, 0. Heredity of supernumerary hngers. Biol. Zentralb., 49: 705-717, 1929. 6. SEIFERLE, E. Atavism and poIydactyIy of hind paws of dog. Morpbol. Jabrb., 57: 313-380 (Jan. 25) 1927. 7. DRAHM, F. PoIvdactvIia in horses. Berl. tierarztl. Wcbnscbr., 43: g4 (Feb. I I) 1927. 8. PANNET, R. C., and PEASE, M. S. PoIydactyIia genetic studies in pouItry. g. NYLANDER, E. D. Pre-axia1 poIydactyIism in five generations of Swedish family. Upsala lakaref jorb, 36: 275-292 (May 22) rg3r. IO. MCCLINTIC. B. S. Five generationsof poIvdactvIism_ Normal heredity, 261141-144 (ApriI) “1935.” I I. MANSON. F. S. Hereditarv svndactvlism and oolvdactyhsm descriptive “of” recen; additions to pedigree. Brit. Med. Jour., 2: 1044 (Dec. 8) ”

_I

‘934. I 2. SCHATZKI. P. ConceaIed

syndactyIic poIydactyIia and triangIe formations in human metacarpus. Arch. Ortbop. (Jan.-March) 1936.