The Extra Finger: A Pain or a Gain?

Extra Finger/Toe Growth is Normally Hereditary

Surgery Options Depends on the Place of Growth

Blessed are our hands to pray to the Almighty, cook delicious food, build homes, key in words, pen down our thoughts and so on and on. What started as tiny structures that erupted when you were an embryo just four weeks old form into tiny fingers and toes that are still webbed. By the 10th week, these structures become distinct and that’s when you get to know whether you have got five or more fingers/toes in your hands/legs! Scientists, researchers and physicians are still perplexed over the number ‘5’ and always wonder whether we would be better off plus or minus one finger. Maybe, that’s why we have got a rare category of people who are born with six fingers where the sixth one mostly erupts as a tiny protrusion.

First day of class after school reopens is always exciting as we look forward to meeting our new class teacher. It was just like every other year and I was in my fourth grade eagerly waiting for my class teacher. In a while she entered the class booming with high spirits like a fresh wave of air. As she placed her belongings on the table I could find a tiny little protrusion extending from her left hand near the little finger. This protrusion waved loose unlike her other fingers that were as solid as her confidence. Distressed, scared, bemused or nervous, you can term it anyway, I spent the entire year praying for it to end as soon as it had all started. Sadly, I was too small to understand this to just be an extra finger which can happen in some people-scientifically called as ‘polydactyly’.

Polydactyly
Originating from the Greek word ‘poly’ (many) and ‘dactylos’ (finger), extra fingers or toes on our hands or legs are named as ‘supernumerary’ directly meaning that this finger/toe is ‘more than the normal number’. There might be an extra toe or finger in either one or both hands or feet. Extremely rarely, hands/legs might comprise of more than six fingers or toes. The extra protrusion might contain no bones but appear as a soft mass of tissue (nubbin), contain a small incomplete bone but no joints hanging down as a partially formed finger or comprise of all features (bones, joints, tissue) present in other five fingers.

There are three types that include:
Preaxial (ulnar) polydactyly or small finger duplication: Here the extra finger grows on the outside of the little finger which is also called as the ulnar side of the hand. The same growth arising in the feet is called as fibular polydactyly.

Postaxial polydactyly or small finger duplication: The extra finger grows on the outside of the thumb, also known as the radial side. But such a growth is comparatively rare. When the same kind of growth occurs in the toes it is called as tibial polydactyly.

Central polydactyly: Going by its name, the growth can occur anywhere near the ring, index or middle finger although this is extremely rare. A similar growth in the toes goes by the same name. Any individual with this condition mostly suffers from webbed hands or feet. Such hands/feet can hinder normal activities and for complete information on this please visit the website www.firsteatright.com.

Reasoning Out!
This condition is generally hereditary and passed down in families known as familial polydactyly. Here, the individual experiences no associated symptoms other than the extra growth. The same growth might arise as a result of some genetic condition in which case both, the polydactyly and the genetic condition are passed over. Sometimes, the genes of a growing fetus can also change while it grows in the womb and in no way is the extra finger a result of inheritance.

Diagnosis & Treatment
The physician usually diagnoses the condition with the help of an x-ray. He/she identifies the bone structure of the hand/foot carrying the extra growth after which questions regarding family history of polydactyly are posed to the individual. Rarely, the condition is diagnosed when the baby is the mother’s womb as a three-month-old fetus.

Treatment depends on the type of polydactyly condition present:

1. If it is the little finger that is duplicated there is not much need for any treatment unless the person wishes to get it removed for cosmetic reasons. When the finger formation involves only tissues but no bones the physician removes it easily by tying a string to the base of the extra finger. This cuts off blood supply and allows the extra tissue to fall off on its own. If the sixth finger is fully formed surgery might be required to remove it
2. When the individual has a duplicated thumb treatment might be mandatory otherwise the person suffers from impaired performance of the other thumb. Removing the extra thumb is not the solution but to reconstruct one fully functional thumb using parts of both thumbs.
3. When an individual suffers from central polydactyly the physician might either reconstruct the finger using both finger parts, remove the extra finger and reconstruct the other finger or keep both fingers and ensure that tendons and ligaments work properly. The decision to do any of these is taken based on which might suit best for the patient after discussing the pros and cons with him/her.
   
   

After surgery, the individual might suffer from infection risk or restricted movement of the reconstructed thumb. Most times, the outcomes are generally positive and simple.

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