Lateral Polydactyly of the Foot: Surgical Outcomes Based on a New Classification

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Congenital Foot Abnormalities

Background:

• Lateral polydactyly of the foot is a congenital condition requiring surgical intervention.
• Existing classification systems may not fully integrate clinical and radiographic features.
• A refined classification is needed for improved surgical planning and outcome prediction.

Purpose of the Study:

• To introduce a novel classification for lateral foot polydactyly.
• To integrate both visual appearance and radiographic findings into the classification.
• To correlate surgical techniques and outcomes with the proposed classification.

Main Methods:

• A retrospective review of 148 feet from 126 patients (January 2009 - July 2021).
• Development of a new classification based on visual appearance (Hirase classification) and radiological bifurcation level (Distal phalanx, Proximal phalanx, Metatarsal).
• Comparison of incidence, surgical procedures, and outcomes across the new classification types.

Main Results:

• The classification identified types A, B1, and B2. Branching levels were D, P, or M.
• Type B2-D was the most common (46%).
• Surgical outcomes varied, with some late sequelae like hammer toe deformities noted in specific types (A-P).

Conclusions:

• The proposed classification, integrating visual and radiographic data, is practical for surgical planning.
• This system aids in predicting surgical outcomes and potential late complications.
• The classification offers a straightforward approach to managing lateral foot polydactyly.