Resection of Postaxial Supernumerary Digits
This chapter describes the surgical procedure for right/left/bilateral Type B postaxial polydactyly excision as performed by the following approaches: suture ligation, vascular clip ligation, and instrumented excision. The text includes an introduction that outlines the indications, risks, alternatives, essential steps, needed equipment, and variations in technique for the procedure. A template operative dictation provides the reader with an operative report such as is found in a patient chart or electronic medical record. A description is provided of the following critical concepts for this procedure: recognition of Type A versus Type B postaxial polydactyly, correct application of the vascular clip or ligature suture, placement of a digital block, cauterization of vascular structures, and proximal excision of the digital nerve. Preaxial polydactyly is outside the scope of this chapter and should be referred to a dedicated pediatric hand surgeon for further evaluation.