# Surgical management of bilateral preaxial and postaxial polydactyly with syndactyly: A case report

## TL;DR

This case report describes a rare condition where a child had extra toes on both feet and fused toes, which were surgically corrected in one operation.

## Contribution

The paper presents a rare case of combined preaxial and postaxial polydactyly with syndactyly and a one-stage surgical solution.

## Key findings

- A one-stage surgical correction was successfully performed for bilateral polydactyly and syndactyly.
- Z-plasty was used to release syndactyly after removing the supernumerary digits.
- The procedure improved both function and cosmetic appearance with minimal patient morbidity.

## Abstract

Polydactyly is the most common congenital malformation in the limbs. However, it is rare for a patient to exhibit concomitant preaxial and postaxial polydactyly alongside syndactyly in both limbs, and there are limited recommendations for such conditions. This report presents a case of bilateral preaxial and postaxial polydactyly with syndactyly of the feet.

A 2-year-old girl was presented with an excess number of toes on both feet and an abnormal connection between the second and third toes. After a physical examination and plain radiography, the patient was diagnosed with bilateral preaxial and postaxial polydactyly with syndactyly. We performed a one-stage surgical correction consisting of ablation at the extra digit of bilateral great and little toes, followed by syndactyly release using z-plasty. The surgery was uneventful, and the parents were satisfied with the result.

A plain radiograph is necessary for pre-operative planning. We discarded the excess digits for cosmetics and soft and hard tissue for optimal function. It is necessary to preserve the soft tissues, remove the auxiliary digit, realign the digit, and restore the ligaments to preserve digit stability.

The complexity of this case required a meticulous surgical approach to address the structural abnormalities, restore functionality, and improve cosmetic appearance. In this case, the surgery can be performed in one procedure to minimize patient morbidity.

•It is rare for a patient to exhibit concomitant preaxial and postaxial polydactyly alongside syndactyly in both feet•We performed a one-stage surgery involving the ablation of supernumerary digits, followed by syndactyly release using z-plasty•We were not only discarding the excess finger for cosmetics but also discarding the soft tissue and hard tissue for optimal function of the feet

It is rare for a patient to exhibit concomitant preaxial and postaxial polydactyly alongside syndactyly in both feet

We performed a one-stage surgery involving the ablation of supernumerary digits, followed by syndactyly release using z-plasty

We were not only discarding the excess finger for cosmetics but also discarding the soft tissue and hard tissue for optimal function of the feet