Postaxial Polydactyly Type B in Infants: A Narrative Review of Outcomes and Family-Centered Care.
- 1Medical Education, Albany Medical College, Albany, USA.
- 2Pediatric Orthopaedics, Lee Memorial Health System, Fort Myers, USA.
Abstract
Postaxial polydactyly type B is a rudimentary ulnar-sided digit attached by a soft-tissue pedicle. Although treatment usually preserves hand function, families must weigh differences in timing, anesthesia, residual appearance, symptoms, and the possibility of another procedure. This narrative review examines the evidence for suture or clip ligation and surgical excision, with particular attention to caregiver experience and the limits of psychosocial outcome data. Targeted literature searches and reference-list review were updated in September 2026. Systematic reviews and observational cohorts generally associate excision with fewer composite complications and less residual prominence, while satisfaction is high after several treatment approaches. Early excision under local anesthesia offers immediate removal and direct management of the neurovascular pedicle when appropriate expertise and facilities are available. Ligation remains an option for selected narrow attachments after discussion of delayed separation and possible residual tissue or revision. Caregiver studies support discussing treatment timing, anesthesia concerns, and satisfaction with appearance; they do not establish that excision prevents childhood bullying, anxiety, or depression. A visible remnant, caregiver dissatisfaction, and child distress should therefore be assessed separately. An anatomy illustration and an author-developed treatment decision aid connect these distinctions to clinical assessment, shared decisions, and follow-up. The pathway includes observation or planned excision when immediate treatment is deferred. Better prospective studies should distinguish initial treatment from revision and measure caregiver concerns separately from the child's later experience.
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BibTeX
@article{gauta2026postaxial,
title = {{Postaxial Polydactyly Type B in Infants: A Narrative Review of Outcomes and Family-Centered Care.}},
author = {Stephen J Gauta and Bryan Bartnick and Luis P Luy and Brett Shannon and Jordan Vokes},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117353},
url = {https://europepmc.org/article/MED/42968856},
note = {CC BY},
}
RIS
TY - JOUR
TI - Postaxial Polydactyly Type B in Infants: A Narrative Review of Outcomes and Family-Centered Care.
AU - Stephen J Gauta
AU - Bryan Bartnick
AU - Luis P Luy
AU - Brett Shannon
AU - Jordan Vokes
PY - 2026
DA - 2026/10/02
JO - Cureus
DO - 10.7759/cureus.117353
UR - https://europepmc.org/article/MED/42968856
AB - Postaxial polydactyly type B is a rudimentary ulnar-sided digit attached by a soft-tissue pedicle. Although treatment usually preserves hand function, families must weigh differences in timing, anesthesia, residual appearance, symptoms, and the possibility of another procedure. This narrative review examines the evidence for suture or clip ligation and surgical excision, with particular attention to caregiver experience and the limits of psychosocial outcome data. Targeted literature searches and reference-list review were updated in September 2026. Systematic reviews and observational cohorts generally associate excision with fewer composite complications and less residual prominence, while satisfaction is high after several treatment approaches. Early excision under local anesthesia offers immediate removal and direct management of the neurovascular pedicle when appropriate expertise and facilities are available. Ligation remains an option for selected narrow attachments after discussion of delayed separation and possible residual tissue or revision. Caregiver studies support discussing treatment timing, anesthesia concerns, and satisfaction with appearance; they do not establish that excision prevents childhood bullying, anxiety, or depression. A visible remnant, caregiver dissatisfaction, and child distress should therefore be assessed separately. An anatomy illustration and an author-developed treatment decision aid connect these distinctions to clinical assessment, shared decisions, and follow-up. The pathway includes observation or planned excision when immediate treatment is deferred. Better prospective studies should distinguish initial treatment from revision and measure caregiver concerns separately from the child's later experience.
SN - 2168-8184
ER -