Classification
Pre-axial / great toe / 15%
Central / 2-4 MT / 5%
Post-axial / 5th MT / 80%
Type A - articulated
Type B - rudimentary
Epidemiology
2 in 1000 births
- 30% positive FHx
- autosomal dominant
Associated MT anomalies common
- block MT / Y-shaped / T-shaped /wide head
Treatment
Rudimentary / Type B
- ligate at birth
- allow to auto-amputate
Articulated / Type A
- excise at 1 year
- do at any time before school
Pre-axial
- medial toe excised
Post-axial
- usually lateral excised
- unless have syndactyly to 4th
- address MT or syndactyly at same sitting
Syndactyly
Types
Polysyndactyly: duplication + webbing
Zygosyndactyly: webbing alone
Acrosyndactyly: distal webbing / Apert's
Managment
Usually none required