Treatment of Polydactyly in Children

Specialist Referral

The American Academy of Pediatrics explicitly recommends pediatric plastic surgeons for hand trauma and malformations in children, including bone, tendon, and skin abnormalities. 1
At 1-2 years of age, this infant falls well within the age range (0-1 year for infants, 2-12 years for children) where pediatric surgical specialists are strongly preferred according to AAP guidelines. 2, 1
If a pediatric plastic surgeon is not locally available, a pediatric surgeon is an acceptable alternative, particularly since all patients 5 years or younger requiring surgical care should be managed by pediatric surgical specialists. 3
A pediatric orthopedic surgeon who manages infants with limb malformations is another appropriate option, as the AAP guidelines specify that infants with malformations of the limbs should be referred to pediatric orthopedic surgery. 2

Immediate referral is appropriate to allow the specialist to determine optimal surgical timing. 1

Avoid attempting treatment by a general surgeon without pediatric training, as outcomes are significantly better when children are operated on by surgeons who preferentially treat pediatric patients. 3
If pediatric surgical expertise is not locally available, contact a pediatric surgeon at a regional pediatric surgical center to discuss whether transfer is necessary, as families should weigh the advantages of traveling to a center with appropriate expertise. 3