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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(03): 232-237
DOI: 10.5999/aps.2013.40.3.232
Original Article

New Classification of Polydactyly of the Foot on the Basis of Syndactylism, Axis Deviation, and Metatarsal Extent of Extra Digit

Hyo Hyun Seok
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
,
Ji Ung Park
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
,
Sung Tack Kwon
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea
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Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis.

Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers.

Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extra-digit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M) followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as S1A2M2.

Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.

Keywords

Polydactyly - Foot - Classification - Syndactyly - Axis

This article was presented at the 69th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 11-13, 2011 in Seoul, Korea.




Publication History

Received: 24 December 2012

Accepted: 07 March 2013

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • References

  • 1 Son WG, Kwon ST, Lee SW. Simple classification of foot polydactyly based on the status of metatarsal bone and varus deformity. J Korean Soc Plast Reconstr Surg 2004; 31: 501-505
    Google Scholar
  • 2 Miura T, Nakamura R, Imamura T. Polydactyly of the hands and feet. J Hand Surg Am 1987; 12: 474-476
    CrossrefPubMedGoogle Scholar
  • 3 Kim HJ, Han SK, Lee BI. et al. Clinical study on polydactyly of the foot. J Korean Soc Plast Reconstr Surg 1997; 24: 317-325
    Google Scholar
  • 4 Venn-Watson EA. Problems in polydactyly of the foot. Orthop Clin North Am 1976; 7: 909-927
    CrossrefPubMedGoogle Scholar
  • 5 Phelps DA, Grogan DP. Polydactyly of the foot. J Pediatr Orthop 1985; 5: 446-451
    CrossrefPubMedGoogle Scholar
  • 6 Masada K, Tsuyuguchi Y, Kawabata H. et al. Treatment of preaxial polydactyly of the foot. Plast Reconstr Surg 1987; 79: 251-258
    CrossrefPubMedGoogle Scholar
  • 7 Watanabe H, Fujita S, Oka I. Polydactyly of the foot: an analysis of 265 cases and a morphological classification. Plast Reconstr Surg 1992; 89: 856-877
    CrossrefPubMedGoogle Scholar
  • 8 Turra S, Gigante C, Bisinella G. Polydactyly of the foot. J Pediatr Orthop B 2007; 16: 216-220
    CrossrefPubMedGoogle Scholar
  • 9 Morley SE, Smith PJ. Polydactyly of the feet in children: suggestions for surgical management. Br J Plast Surg 2001; 54: 34-38
    CrossrefPubMedGoogle Scholar
  • 10 Blauth W, Olason AT. Classification of polydactyly of the hands and feet. Arch Orthop Trauma Surg 1988; 107: 334-344
    CrossrefPubMedGoogle Scholar
  • 11 Wassel HD. The results of surgery for polydactyly of the thumb. A review. Clin Orthop Relat Res 1969; 64: 175-193
    PubMedGoogle Scholar
  • 12 Stelling F. The upper extremity. In: Fergusion AB. Orthopedic surgery in infancy and childhood. 1963. Baltimore: Lippincott Williams & Wilkins; 304-309
    Google Scholar
  • 13 Konno M, Hirase Y. A clinical review of polydactyly in the foot and postoperative results of lateral ray polydactyly. J Jpn Soc Plast Reconstr Surg 1997; 17: 211-225
    Google Scholar
  • 14 Coppolelli BG, Ready JE, Awbrey BJ. et al. Polydactyly of the foot in adults: literature review and unusual case presentation with diagnostic and treatment recommendations. J Foot Surg 1991; 30: 12-18
    PubMedGoogle Scholar
  • 15 Uda H, Sugawara Y, Niu A. et al. Treatment of lateral ray polydactyly of the foot: focusing on the selection of the toe to be excised. Plast Reconstr Surg 2002; 109: 1581-1591
    CrossrefPubMedGoogle Scholar