From: Burger et al Acta Orthopaedica 2018
Epidemiology
2 in 1000 births
30% positive family history / autosomal dominant
Xray
Associated metatarsal anomalies common
- block metatarsal / Y-shaped / T-shaped
Classification
Type A - articulated
Type B - rudimentary
| Pre-axial | Central | Post-axial |
|---|---|---|
| Great toe / 1st metatarsal | 2-4 metatarsal | 5th metatarsal |
| 15% | 5% | 80% |
Management
Type B Rudimentary
Ligate at birth
- allow to auto-amputate
Type A Articulated
Excise at 1 year
- do at any time before school
- pre-axial: medial toe excised
- post-axial: excise lateral toe
Syndactyly
Types
Polysyndactyly: duplication + webbing
Zygosyndactyly: webbing alone
Acrosyndactyly: distal webbing / Apert's
Management
Usually none required