Postaxial Polydactyly Type B in Infants: A Narrative Review of Outcomes and Family-Centered Care.

Authors

Stephen J Gauta, Bryan Bartnick, Luis P Luy, Brett Shannon, Jordan Vokes

Published in

Cureus. Volume 18. Issue 10. Pages e117353. Epub Oct 02, 2026.

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.

PMID:
42968856
Bibliographic data and abstract were imported from PubMed on 02 Nov 2026.

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