Polydactyly of the foot: manifestations and treatment

Polydactyly of the foot is not an uncommon foot problem. However, it is not well understood and not often reported. Its clinical manifestations vary, as do treatment methods and results. During the period of 1979 to 1994, 54 children with polydactyly of 65 feet were treated in our clinic. Bilateral involvement was seen in 11 patients, and six had accompanying polydactyly of the hand. By Blauth and Olason's classification, duplication of the fifth ray (43 feet) was most common, followed by first ray duplication (20 feet) and other ray duplication (2 feet). A rudimentary form was found in one foot. Polysyndactyly was present in 18 feet. Hallux varus was the most common associated problem and was present in seven feet. Surgery for both cosmetic and functional purposes was performed in 38 patients (44 feet). Treatment included excision of the extra toe and reconstruction of the soft tissue around the remaining toe, of which the alignment was restored in cases of deviation. Results were evaluated with Phelps-Grogan's protocol; 39 feet (88%) were classified as having excellent results, two (5%) had good, and three (7%) had poor results. Postoperative complications included residual hallux varus in three feet with polydactyly of the first ray, and unpleasant surgical scars in another two. We conclude that polydactyly of the foot should be treated individually, depending on classification. Special attention should be paid to complex first ray polydactyly.