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Polydactyly refers to the condition in which an individual has more than the typical number of digits on their hands or feet. The word “polydactyly” comes from the Greek words “poly,” meaning “many,” and “dactylos,” meaning “finger” or “toe.” There are several types of polydactyly, ranging from a small extension of tissue on the side of a digit to the presence of a fully formed extra digit.

Rudimentary polydactyly refers to a type of polydactyly in which the extra digit is incompletely formed or is smaller than the typical digits. This type of polydactyly can occur in different forms and can be classified into different types based on the location and appearance of the extra digit. The following are the types of rudimentary polydactyly:

Preaxial Polydactyly: This type of polydactyly occurs on the thumb side of the hand or the big toe side of the foot. In this type, the extra digit is usually located on the radial side of the hand (thumb side) or on the lateral side of the foot (big toe side).
Postaxial Polydactyly: This type of polydactyly occurs on the little finger side of the hand or the small toe side of the foot. In this type, the extra digit is usually located on the ulnar side of the hand (little finger side) or on the medial side of the foot (small toe side).
Central Polydactyly: This type of polydactyly occurs in the middle of the hand or foot, and the extra digit is located between the typical digits. This type is less common than the preaxial or postaxial forms.
Terminal Transverse Deficiency: This type of polydactyly occurs when the extra digit is located at the end of the hand or foot and is transverse, meaning it is oriented perpendicular to the typical digits. In this type, the extra digit may be partially formed or may be only a small nub of tissue.
Bifurcated Polydactyly: This type of polydactyly occurs when the extra digit is split into two parts, resembling a fork. The bifurcation may occur at the base or at the tip of the digit.

Causes

Potential causes for rudimentary polydactyly.

Genetic Causes: The most common cause of rudimentary polydactyly is a genetic mutation. This can be due to autosomal dominant or autosomal recessive inheritance patterns. In autosomal dominant inheritance, a single copy of the mutated gene is enough to cause the condition, while in autosomal recessive inheritance, two copies of the gene are required. Some of the genes associated with rudimentary polydactyly include GLI3, ZIC2, and HOXD13.
Chromosomal Abnormalities: Chromosomal abnormalities can also cause rudimentary polydactyly. This can occur due to an extra chromosome or missing chromosome, leading to conditions such as Down syndrome, Turner syndrome, or Trisomy 13.
Teratogenic Factors: Teratogenic factors refer to substances or events that can cause birth defects. This can include exposure to alcohol, tobacco, or drugs during pregnancy, as well as exposure to radiation or infections such as rubella.
Environmental Factors: Environmental factors, such as maternal malnutrition or exposure to toxins, can also cause rudimentary polydactyly. For example, mothers who smoke during pregnancy have a higher risk of having children with this condition.
Familial Pattern: Rudimentary polydactyly can also occur as a result of a familial pattern, where it is passed down from generation to generation within a family. This can be due to a combination of genetic and environmental factors.
Syndromic Association: Rudimentary polydactyly can also be associated with certain syndromes, such as Ellis-van Creveld syndrome, Pallister-Hall syndrome, or Acrocallosal syndrome. These syndromes are characterized by a combination of physical, intellectual, and medical problems.
Mosaicism: Mosaicism refers to the presence of two or more genetically different cell lines in an individual. This can lead to the development of rudimentary polydactyly, as well as other physical and intellectual abnormalities.
Reduced Folic Acid Intake: Reduced folic acid intake during pregnancy can also lead to the development of rudimentary polydactyly. Folic acid is important for normal embryonic development and a lack of it can result in birth defects.
Maternal Diabetes: Maternal diabetes can also increase the risk of having a child with rudimentary polydactyly. This is because high blood sugar levels can affect fetal development and increase the risk of birth defects.
Maternal Obesity: Maternal obesity can also increase the risk of having a child with rudimentary polydactyly. This is because excessive weight can affect fetal development and increase the risk of birth defects.
Advanced Maternal Age: Advanced maternal age, or having a baby at an older age, can also increase the risk of having a child with rudimentary polydactyly. This is because the risk of birth defects increases as a woman ages.
Multiple Pregnancies: Multiple pregnancies, such as twins or triplets, can also increase the risk of having a child with rudimentary polydactyly. This is because multiple pregnancies can increase the risk of birth defects and other complications.

Symptoms

The symptoms of this condition vary depending on the type and severity of the abnormality. Here is a list of symptoms that are commonly associated with rudimentary polydactyly:

Presence of an extra digit: The most obvious symptom of rudimentary polydactyly is the presence of an extra digit on the hand or foot.
Abnormal shape of the extra digit: The extra digit may be smaller or differently shaped than the other fingers or toes.
Abnormal positioning of the extra digit: The extra digit may be positioned differently than the other fingers or toes, either closer to the thumb or farther away from the other digits.
Weakness or absence of muscle tone in the extra digit: The extra digit may have weaker or absent muscle tone, making it difficult to move or control.
Abnormal joint flexibility in the extra digit: The extra digit may have limited or increased joint flexibility, making it difficult to use the digit for fine motor tasks.
Numbness or tingling in the extra digit: Some individuals with rudimentary polydactyly may experience numbness or tingling in the extra digit, indicating nerve damage.
Pain or discomfort in the extra digit: The extra digit may be painful or uncomfortable, especially when it is being used for fine motor tasks.
Abnormal nail growth in the extra digit: The nail on the extra digit may be abnormally shaped or grow at an unusual rate.
Abnormal skin texture in the extra digit: The skin on the extra digit may be thicker or have a different texture than the skin on the other fingers or toes.
Abnormal sweating in the extra digit: The extra digit may sweat more or less than the other fingers or toes.
Abnormal temperature in the extra digit: The extra digit may feel colder or hotter than the other fingers or toes.
Abnormal coloration in the extra digit: The extra digit may have a different color than the other fingers or toes, indicating a circulation issue.
Abnormal hair growth in the extra digit: The extra digit may have hair growth that is different from the other fingers or toes.
Abnormal bone structure in the extra digit: The bone structure in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape.
Abnormal muscle development in the extra digit: The muscle development in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape.
Abnormal tendon development in the extra digit: The tendon development in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape.
Abnormal ligament development in the extra digit: The ligament development in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape.
Abnormal nerve development in the extra digit: The nerve development in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape or function.
Abnormal blood vessel development in the extra digit: The blood vessel development in the extra digit may be different from the other fingers or toes, causing the digit to have an unusual shape or function.
Abnormal skin crease in the extra digit: The skin crease in the extra digit may be different from the other fingers

Diagnosis

The diagnosis and management of this condition depend on several factors, including the number and location of the extra fingers, the presence of other anomalies, and the patient’s age, occupation, and lifestyle. In this article, we will discuss 20 different tests and diagnoses that may be used to evaluate and manage rudimentary polydactyly.

Clinical Examination: A thorough clinical examination is the first step in the evaluation of rudimentary polydactyly. During the examination, the physician will assess the number, location, and size of the extra fingers, as well as the presence of any other anomalies. The physician may also ask the patient about any family history of polydactyly or related conditions.
Radiographs: Radiographs, such as X-rays, can provide valuable information about the bones and joints involved in rudimentary polydactyly. Radiographs can help the physician determine the number of bones present in the extra fingers and assess the quality of the bones and joints.
Computed Tomography (CT) Scan: A CT scan can provide detailed images of the bones and soft tissues involved in rudimentary polydactyly. This test can help the physician determine the presence of any underlying bony anomalies and assess the blood supply to the extra fingers.
Magnetic Resonance Imaging (MRI): An MRI can provide detailed images of the soft tissues involved in rudimentary polydactyly, including the nerves, tendons, and muscles. This test can help the physician determine the presence of any underlying nerve or tendon anomalies and assess the blood supply to the extra fingers.
Ultrasound: An ultrasound can be used to assess the blood flow to the extra fingers and determine the presence of any underlying anomalies. This test can also help the physician determine the presence of any fluid-filled cysts or tumors that may be associated with rudimentary polydactyly.
Angiogram: An angiogram is an X-ray that uses a special dye to visualize the blood vessels. This test can be used to assess the blood supply to the extra fingers and determine the presence of any underlying vascular anomalies.
Electromyogram (EMG): An EMG is a test that measures the electrical activity of the muscles. This test can be used to assess the nerve supply to the extra fingers and determine the presence of any underlying nerve anomalies.
Nerve Conduction Study (NCS): A NCS is a test that measures the electrical activity of the nerves. This test can be used to assess the nerve supply to the extra fingers and determine the presence of any underlying nerve anomalies.
Hand Grip Strength Test: The hand grip strength test measures the strength of the hand muscles. This test can be used to assess the function of the extra fingers and determine the impact of rudimentary polydactyly on the patient’s hand strength.
Hand Dexterity Test: The hand dexterity test measures the ability of the hand to perform fine motor tasks. This test can be used to assess the function of the extra fingers and determine the impact of rudimentary polydactyly on the patient’s hand dexterity.
Range of Motion (ROM) Test: The ROM test measures the ability of the hand to move through its full range of motion. This test can be used to assess the function of the extra fingers and determine the impact of rudimentary polydactyly on the patient’s hand mobility.
Sensory Testing: Sensory testing can be used to assess the sensation in the extra fingers. This test can

Treatment

There are various treatments available for rudimentary polydactyly, ranging from conservative measures to surgical interventions. Here are of the most common treatments:

Observation: In some cases, rudimentary polydactyly may not cause any functional limitations or discomfort, and no treatment may be necessary. In these instances, simple observation may be recommended.
Splinting: For individuals with rudimentary polydactyly who experience discomfort or pain, splinting may be recommended to help alleviate symptoms. A splint can be custom-made to fit the individual’s hand and provide support to the affected area.
Physical therapy: Physical therapy may be recommended to help individuals with rudimentary polydactyly improve their range of motion and dexterity. This can be especially helpful for individuals who have limited mobility or who experience discomfort or pain.
Occupational therapy: Occupational therapy may be recommended to help individuals with rudimentary polydactyly improve their ability to perform daily activities. This may involve the use of assistive devices or the teaching of adaptive techniques.
Injection therapy: Injection therapy may be recommended for individuals with rudimentary polydactyly who experience pain. Corticosteroid injections can help reduce inflammation and relieve pain.
Pain medication: Pain medication may be prescribed for individuals with rudimentary polydactyly who experience discomfort or pain. This may include over-the-counter pain relievers, such as ibuprofen, or prescription pain medication, such as opioids.
Nerve blocks: Nerve blocks may be recommended for individuals with rudimentary polydactyly who experience pain. A nerve block involves injecting a local anesthetic into the affected area to block pain signals.
Acupuncture: Acupuncture may be recommended for individuals with rudimentary polydactyly who experience pain. This ancient Chinese therapy involves the insertion of thin needles into specific points on the body to stimulate healing.
Massage therapy: Massage therapy may be recommended for individuals with rudimentary polydactyly who experience discomfort or pain. Massage can help improve circulation and reduce tension in the affected area.
Chiropractic care: Chiropractic care may be recommended for individuals with rudimentary polydactyly who experience discomfort or pain. A chiropractor can provide manual adjustments to help realign the spine and alleviate pain.
Ultrasound therapy: Ultrasound therapy may be recommended for individuals with rudimentary polydactyly who experience discomfort or pain. This therapy uses high-frequency sound waves to penetrate deep into the affected area and reduce pain.
Hot and cold therapy: Hot and cold therapy may be recommended for individuals with rudimentary polydactyly who experience discomfort or pain. Alternating between hot and cold compresses can help reduce pain and improve circulation.
Transcutaneous electrical nerve stimulation (TENS): TENS may be recommended for individuals with rudimentary polydactyly who experience pain. This therapy uses low-voltage electrical stimulation to block pain signals.
Exercise: Exercise may be recommended for individuals with rudimentary polydactyly to help improve range of motion, dexterity, and overall function. This may include stretching, strength training, and cardiovascular exercise.

References