Post - axial polydactyly in four limbs with different bony configurations

Polydactyly is a common congenital digital variation of the hand and foot, which is characterized by supernumerary digits. This condition can occur in one limb or can be exceptionally present in all four limbs; a condition called tetrapolydactyly. It may appear as isolated or in association with other birth defects. Polydactyly might be pre-axial, postaxial and central type, the post-axial being the commonest one [1]. Previously, occurrence of polydactyly was explained as the consequence of the failure of programmed cell death during fetal limb development. Early theories for polydactyly concerned disorders were programmed cell death cycle of fetal limb development. But now, specific genetic malfunctions are thought responsible. Hexadactyly of all the four limbs is a very rare skeletal malformation. Wollina et al. described such a case of pure post-axial polydactyly involving all the four limbs but no radiological investigation was possible in that case [2]. Surgical intervention in polydactyly are indicated for various reasons. To have a successful surgical procedure detailed knowledge regarding the bony architecture of the region is necessary. We here present a case of polydactyly involving all the four limbs where bony architecture is grossly different in the different limbs, knowledge of which will help the surgeons to plan the different surgical procedures. Case Report