Polydactyly - Knowledge (XXG)

238:, and connected to the hand with a small skin pedicle. Mostly one neurovascular bundle can be identified, with no tendons present in the extra digit. In case of a fully developed extra finger, the duplication usually presents itself at the level of the metacarpophalangeal joint. A triplication of the little finger is very rare. Ulnar polydactyly occurs ten times more often in African populations. The incidence in Caucasians is reported as 1 in 1,339 live births, compared with 1 in 143 live births in Africans. Ulnar polydactyly is also often part of a syndrome. In patients with African ancestry ulnar polydactyly mostly occurs isolated, whereas the presentation in Caucasians is often associated with a syndrome, though in a retrospective review, only 4 of 37 cases of ulnar polydactyly in Caucasians were syndromic. 1016: 646: 1512: 1524: 982:

secondary surgical procedures to address flexion contractures and angular deviation at the IP joint level. However, several primary factors contribute to the complexity of central polydactyly reconstruction. Hypoplastic joints and soft tissues that predispose the reconstructed finger to joint contracture, and angular deformities as well as complex tendon anomalies, are often difficult to address. Therefore, treatment is wholly dependent on the anatomic components present, the degree of syndactyly, and the function of the duplicated finger.

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overall complication rate of 23.5% was reported, citing a residual tender or unacceptable bump in 16%, infection in 6%, and bleeding in 1% of patients. In general, suture ligation is safe and effective when applied to appropriate cases of Type B polydactyly in which no substantial ligamentous or osseous structures are present within the pedicle. Parents should be educated as to the progression of necrosis, and that revision of residual tissue or scar may be necessary when the child is six months of age or older.

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hand disorder. The incidence of radial polydactyly is reported as 1 in every 3,000 live births. The clinical features of radial polydactyly will depend upon the extent of duplication. Radial polydactyly varies from a barely visible radial skin tag to complete duplication. Thumb polydactyly varies from barely visible broadening of the distal phalanx to full duplication of the thumb including the first metacarpal. Radial polydactyly is frequently associated with several syndromes.

872:. In most cases, a longitudinal and sagittal osteotomy is needed to centralize the bony parts of the ulnar thumb. While the soft-tissue of the radial thumb was preserved, it is now attached to the radial side of the ulnar thumb together with the periosteal sleeve. The APB and FPB of the ablated radial thumb are attached to the distal phalanx for more stability. If necessary, the extensor pollicis longus and the flexor pollicis longus are reattached to centralize their course. 991: 683: 209:) side, and very rarely within the middle three digits. These are respectively known as postaxial (little finger), preaxial (thumb), and central (ring, middle, index fingers) polydactyly. The extra digit is most commonly an abnormal fork in an existing digit, or it may rarely originate at the wrist as a normal digit does. Polydactyly can be divided into three major types, which are discussed below, which depend on the location of the additional digit. 766: 700: 222: 719: 247: 749:

IIA is a nonsyndactylous duplication of a digit or part of a digit with normal components, and articulates with a broad or bifid metacarpal or phalanx. Type IIB is a syndactylous duplication of a digit or part of a digit with normal components, and articulates with a broad or bifid metacarpal or phalanx. Type III is a complete digital duplication, which has a well-formed duplicated metacarpal.

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rebalancing. Also, the collateral ligaments must be preserved or reconstructed. Wide articular surfaces should be narrowed and phalangeal wedge osteotomies may be required to provide an axial alignment. Attention must also be given to reconstruct the intermetacarpal ligament. Furthermore, one should take in mind the provision for adequate web-space soft tissue.

1412:. The breed standard of these varieties of chickens calls for five toes on each foot, although sometimes more than five toes will occur. The extra digit in these breeds presents as an extra "thumb" that does not touch the ground. Mixed-breed chickens may also have extra digits if the aforementioned breeds are part of their genetic makeup. 727:

little finger can be hypoplastic or fully developed. Type B varies from a nubbin to an extra, non-functional little finger part on a pedicle. According to the three-type classification, type I includes nubbins or floating little fingers, type II includes duplications at the MCPJ, and type III includes duplications of the entire ray.

312:(ZPA) on the posterior limb side. From there it diffuses anteriorly, laterally to the growth direction of the limb. In the mutant, smaller ectopic expression in a new organiser region is seen on the anterior side of the limb. This ectopic expression causes cell proliferation delivering the raw material for one or more new digits. 956:

Nail deformity could also occur after reconstruction. Although the joints are stable, restriction of flexion may be possible. The average IP flexion in a reconstructed thumb is 55 degrees less than the contralateral thumb. MCP flexion averaged 55 degrees in reconstructed thumbs, compared to 75 degrees in the contralateral thumb.

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well as a size mismatch. Thumbs are defined as unacceptable if IP joint deviation exceeds 15 degrees, MCP joint deviation exceeds 30 degrees, and thumb size is inappropriate based on the examiner's assessment. Also, thumb size one-third greater or less than the contralateral thumb is defined as unacceptable.

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The classification of central polydactyly is based on the extent of duplication and involves the following three types: Type I is a central duplication, not attached to the adjacent finger by osseous or ligamentous attachments; it frequently does not include bones, joints, cartilage, or tendons. Type

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Advantages: The reconstructed joints tend to remain flexible. Also, it preserves the nail bed and physis, this increases the prevention of nail deformities over time. Disadvantages: Although surgeons try to obtain a stable thumb of appropriate size, instability of the IP and MCP joint may occur, as

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At the level of the mid-proximal phalanx or mid-metacarpal, the distal component is transferred to the proximal component. The tendons of the distal component are preserved as the rest of the distal component is amputated. The neurovascular bundle which supplies the distal component is reserved and

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This type of procedure is used for all Wassel types of polydactyly and is the most commonly used technique. It is recommended in all cases of thumb duplication with a hypoplastic, less-functional thumb. Otherwise, one could consider the Bilhaut-Cloquet. The ulnar thumb is preferably preserved as it

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Because neither of the two thumb components is normal, a decision should be taken on combining which elements to create the best possible composite digit. Instead of amputating the most hypoplastic thumb, preservation of skin, nail, collateral ligaments and tendons is needed to augment the residual

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to devise the skin bridge of the newborn child. This might be easier than an excision of the extra digit when the child is 6 to 12 months old. Ligation occludes the vascular supply to the duplicated digit, resulting in dry gangrene and subsequent autoamputation. This must be done with consideration

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This is a less common situation, in which the affectation is on the side of the hand towards the thumb. Radial polydactyly refers to the presence of an extra digit (or extra digits) on the radial side of the hand. It is most frequent in Indian populations and it is the second most common congenital

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Handschuh, Karen; Feenstra, Jennifer; Koss, Matthew; Ferretti, Elisabetta; Risolino, Maurizio; Zewdu, Rediet; Sahai, Michelle A.; Bénazet, Jean-Denis; Peng, Xiao P.; Depew, Michael J.; Quintana, Laura; Sharpe, James; Wang, Baolin; Alcorn, Heather; Rivi, Roberta; Butcher, Stephen; Manak, J. Robert;

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Advantages: By combining two hypoplastic thumbs a sufficient thumb size is acquired. Furthermore, the IP and MCP joints are very stable as the collateral ligaments are not violated during reconstruction. Disadvantages: Violation during reconstruction can lead to growth arrest or asymmetric growth.

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In a study on 21 patients with Type B ulnar polydactyly treated with suture ligation it was found that the duplicated digit was typically amputated at an average of 10 days and no complications of infection or bleeding were reported. In a large study on 105 patients treated with suture ligation an

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There are no substantive outcome studies regarding the function of these hands following surgical intervention. This is mainly caused by the fact that there is a generally normal function of these patients’ hands following ablation with collateral ligament reconstruction. In a study on 27 patients

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The surgical treatment of central polydactyly is highly variable. After the surgery the hand must be functional and stable, but also aesthetically pleasing. This requires intraoperative creativity and flexibility. The surgeon must also consider whether retention of a fully functional supranumerary

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This type of procedure is recommended for Wassel types 1 and 2 (in which both thumbs are severely hypoplastic) by some congenital hand surgeons. The technique contains a composite wedge resection of the central bone and soft-tissue. This will be achieved with approach of the lateral tissue of each

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are then elevated with a periosteal sleeve. The duplicated extensor and flexor tendons to the ulnar digit are transected and after that the digit is amputated at its articulation with the metacarpal. If the articular surface is wide the metacarpal may be shaved. At last the collateral ligament and

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The classification of ulnar polydactyly exists of either two or three types. The two-stage classification, according to Temtamy and McKusick, involves type A and B. In type A there is an extra little finger at the metacarpophalangeal joint, or more proximal including the carpometacarpal joint. The

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Zhang, Jia-Yu; Gong, Ting-Ting; Huang, Yan-Hong; Li, Jing; Liu, Shu; Chen, Yan-Ling; Li, Li-Li; Jiang, Cheng-Zhi; Chen, Zong-Jiao; Wu, Qi-Jun (1 August 2020). "Association between maternal exposure to PM10 and polydactyly and syndactyly: A population-based case-control study in Liaoning province,

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This type is indicated when one thumb is larger proximally and the other thumb has a larger distal component. (The procedure is initially described as a way to lengthen amputated digits.) The goal is to create a functional thumb by combining less-hypoplastic components. On top plasty procedure is

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The condition has an estimated occurrence of 0.3–3.6 per 1000 live births. Postaxial hand polydactyly is most frequent in the United States in Black males. Preaxial polydactyly occurs in 0.08 to 1.4 in 1,000 live births. In the United States, it is more common in White people and also relatively

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Few clinical outcome studies exist regarding the treatment of central polydactyly. Tada and colleagues note that satisfactory surgical correction of central polydactyly is difficult to achieve and that outcomes are generally poor. In Tada's study, 12 patients were reviewed. All patients required

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The treatment of Type A ulnar polydactyly is complex as its goal is to remove the accessory digit while maintaining a stable, functional small finger. When the duplicated proximal phalanx articulates with a common, broad metacarpal head, the ulnar collateral ligament must be considered. In those

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Elevation of the APB and FPB is performed in Wassel type 4 duplication; this can be accomplished via the periosteum or separately. As the tendons insert proximally, the elevation is performed proximally too to potentially rebalance the ulnar thumb. After the radial thumb is amputated, the ulnar

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Cases of polysyndactyly are approached through a standard opposing zig-zag incision. The incision is favored toward the accessory digit, preserving extra skin for subsequent closure. Depending on the level and extent of duplication, the flexor and extensor tendons may require centralization or

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In Wassel type 5 and 6 the opponens pollicis muscle must be transferred to the ulnar metacarpal. Soft tissue with collateral ligament reconstruction is used to avoid any angular deformity in the preserved thumb. Tendon centralization is also often used for correction. Still, cases with osseous

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This is the most common situation, in which the extra digit is on the ulnar side of the hand, thus the side of the little finger. This can also be called postaxial polydactyly. It can manifest itself very subtly, for instance only as a nubbin on the ulnar side of the little finger, or very

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In humans/animals this condition can present itself on one or both hands or feet. The extra digit is usually a small piece of soft tissue that can be removed. Occasionally it contains bone without joints; rarely it may be a complete functioning digit. The extra digit is most common on the

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In 1961, Frantz and O’Rahilly proposed that congenital anomalies of the limb could be classified in seven categories, based on the embryonic failure causing the clinical presentation. These categories are failure of formation of parts, failure of differentiation, duplication, overgrowth,

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In 2019 it was found that in cases of polydactyly with a fully functional additional digit, muscles to control the extra digit may be duplicated, resulting in increased motor control that allows the patient to carry out certain tasks with one hand that would normally require two.

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In this situation there is an absence of osseous and ligamentous structures. The surgical technique is analogous to radial polydactyly, in which the level of duplication and anatomical components should guide operative treatment. The pedicled ulnar extra digit can be removed by

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Right-sided duplication of the right little toe in an 8.5 months old male, with two toes (fifth and sixth) apparently forming joints with the fifth metatarsal bone, which is mildly broadened distally. The duplicated toes have almost normal growth. The fifth toe has mild

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Complications include: painful scarring, infection, joint instability, residual deformity, angulated growth, growth arrest, joint stiffness, and nail bed deformities. A 2014 study reported a 19% revision rate for preaxial polydactyly for pain or instability.

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By detaching the radial collateral ligament from distal to proximal, a periosteal sleeve can be preserved. In this way, the radial collateral band of the radial digit will function as the absent radial collateral ligament of the preserved ulnar thumb.

1007:, Sweden. This study found incidence of all types of polydactyly at rates of 2.3 per 1000 live births of White males, 0.6 per 1000 live births of White females, 13.5 per 1000 live births of Black males, and 11.1 per 1000 live births of Black females. 263:

This is a very rare situation, in which the extra digit is on the ring, middle or index finger. Of these fingers, the index finger is most often affected, whereas the ring finger is rarely affected. This type of polydactyly can be associated with

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are reinserted at the base of the preserved proximal phalanx and a wire is then placed across the reconstructed joint. In patients with a duplicated metacarpal, the accessory digit is amputated in a standard ray fashion with transfer of the

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is the most widely used classification of radial polydactyly, based upon the most proximal level of skeletal duplication. The most common type is Wassel 4 (about 50% of such duplications) followed by Wassel 2 (20%) and Wassel 6 (12%).

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point of view, polydactyly is a phenotypic variation or innovation, as the fingers and toes arise in places where nothing is phenotypically present in the wild type. Although it is initiated by a point mutation, it occurs as a

327:. But mutation in a variety of genes can give rise to polydactyly. Typically the mutated gene is involved in developmental patterning, and a syndrome of congenital anomalies results, of which polydactyly is one feature or two. 933:

undergoing surgical excision for Type A ulnar polydactyly, only one complication was noted in the form of an infection. However, no investigators have objectively reviewed functional range of motion or articular stability.

670:: 2 additional toes occur much more frequently than 4, these more frequently than 6 or 8 additional ones. Also, for the evo-devo theory, polydactyly cannot be adequately explained by genetic mutation alone, but only by 1387:

Polydactyly occurs in numerous types of animals. The condition is sporadically seen in livestock, where it affects cattle, sheep, pigs, and occasionally horses. Conversely, it is a common trait in several heritage

783:) must be preserved. In patients with a common metacarpal articulation an elliptical incision at the base of the post-axial digit is made. This incision may be extended proximally in order to adequately expose the 1267:, revealed on the show that she was born with an extra thumb on her left hand, three extra toes on one foot, and two extra toes on her other foot. Her extra fingers and toes were surgically removed at a young age. 901:

digit is preferable to surgical intervention. In contrast, a functional, four-fingered hand achieved via ray amputation may be preferable to a five-fingered hand with a deformed or stiff reconstructed finger.

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In the specific case of preaxial polydactyly (Hemingway mutant), a cis-acting mutation approximately 1Mb upstream of SHH gene has been implicated. Normally SHH is expressed in an organiser region, called the

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As of 2022, for infants with ulnar type B polydactyly the recommended treatment is surgical excision or suture ligation, when no bony structures exist. Complications of ligation include infection,

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thumb. The goal is to achieve a normal thumb, what concerns the size, which is possible. If the width of the nail bed is greater than 70% of the contralateral thumb, it may be split.

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undergrowth, congenital constriction band syndrome, and generalized skeletal abnormalities. In 1976 this was modified by Swanson. Polydactyly belongs to the category of duplication.

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and polydactyly of the feet. This can be a simple or complex polydactyly. Ulnar polydactyly occurs as an isolated congenital condition, but can also be part of a syndrome, such as:

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Fryns JP, Bonnet D, De Smet L (1996). "Holt-Oram syndrome with associated postaxial and central polydactyly. Further evidence for genetic heterogeneity in the Holt-Oram syndrome".

1053:, Hungarian poet born with six fingers, but one was removed as a child. The poet later interpreted it as a sign of his selection (according to the ancient Hungarian belief, the 826:

in the neonatal nursery. A 2011 study opined that excision of an extra digit in the neonatal nursery was a safe and simple procedure with a good clinical and cosmetic outcome.

645: 2868:(2014) Biased polyphenism in polydactylous cats carrying a single point mutation: the Hemingway model for of digit novelty. Evolutionary Biology, 41 (2), 262-275, 29, 2014 2366:(2014) Biased polyphenism in polydactylous cats carrying a single point mutation: the Hemingway model for of digit novelty. Evolutionary Biology, 41 (2), 262-275, 29, 2014 2325:

Tada, Koichi; Kurisaki, Eiji; Yonenobu, Kazuo; Tsuyuguchi, Yuichi; Kawai, Hideo (September 1982). "Central polydactyly—A review of 12 cases and their surgical treatment".

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deformities may happen. To provide alignment, osteotomies are necessary to be done. This operation may need bone grafting, which is obtained from the amputated thumb.

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Male with unilateral preaxial polydactyly affecting the left thumb. The supernumerary digit had normal sensation but no joint and hence could not move independently.

3366: 1213:, is the world record holder for highest number of digits. He was born in 2010 with seven digits on each hand and 10 digits on each foot, for a total of 34 digits. 292:

responsible for the expression of a specific gene. Mutations in Hoxa- or Hoxd clusters are reported leading to polydactyly. Interactions of Hoxd13 and GLI3 induce

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Tada, K; Yonenobu, K; Tsuyuguchi, Y; Kawai, H; Egawa, T (June 1983). "Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases".

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of the presence of a neurovascular bundle, even in very small skin bridges. When the ligation is done inappropriately it can give a residual nubbin. Also, a

674:, i.e. the ability of development to produce a complex phenotypic output. The corresponding symbolic generation of toes can now be shown in computer models. 1082: 1246:, a Roman poet of the 1st century, probably received his epithet, signifying "Sixfinger", because he was born with six fingers on each hand, according to 483:

for other congenital anomalies. This should also be done if a syndrome is suspected, or if more than two or three generations of the family are affected.

5101: 1233:, Chicago-based American blues guitarist, was born with polydactyly on both hands, although around age 41, he removed the extra finger on his right hand. 3910: 1446:

gene, in dogs, humans, and mice, can cause polydactyly. A 2014 report indicated that mice could also exhibit polydactyly arising from mutation in the

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thumb. Surgery is recommended in the first year of life, generally between 9 and 15 months of age. Surgical options depend on type of polydactyly.

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As of 2009, research has shown that the majority of congenital anomalies occur during the 4-week embryologic period of rapid limb development.

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Bilhaut M. (1889). "Guérison d'un pouce bifide par un nouveau procédé opératoire" [Healing of a bifid thumb by a new surgical procedure].

1547: 479:(known genetic defect) or association (genetic defect not known), children with a congenital upper extremity deformity should be examined by a 5203: 3894: 3784: 1077: 4289: 3620: 2477:

Lettice LA, Williamson I, Wiltshire JH, Peluso S, Devenney PS, Hill AE, Essafi A, Hagman J, Mort R, Grimes G, DeAngelis CL, Hill RE (2012).

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Kamani Hubbard, a boy in California, was born in 2009 with a rare case of polydactyly, with 12 fingers and 12 toes, all fully functional.

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can develop in the area of the scar. An excision can prevent the development of a residual nubbin and the sensitivity due to a neuroma.

2428:"Point mutations in a distant sonic hedgehog cis-regulator generate a variable regulatory output responsible for preaxial polydactyly" 671: 4084: 3396:

Pérez López, Laura M.; Gutiérrez de la Iglesia, Diego; Cabrera González, Marisa (21 August 2018). "Radial Polydactyly. What's New?".

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Johann Jacob Freiherr von Moscon (1621–1661), Lower Styrian baron, is depicted with six fingers at his left hand on a portrait from

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Sander, P.M. (2000). "Ichthyosauria: their diversity, distribution, and phylogeny". Paläontologische Zeitschrift. 74 (1–2): 1–35.

3505: 3153: 1360:, had six toes on each foot. Among the many previous Ushiromiya family heads, those with polydactyly were known for their wisdom. 1312: 1288: 1034: 4996: 1296:

is described as having mid-ray duplication polydactyly (a duplicated middle finger) on his left hand, which he later removes in

4715: 3547: 1473:, the extinct amphibians that represented the earliest landliving vertebrates. Their number of toes fluctuated until the early 558: 3672: 1486: 31: 3932: 562: 526: 2526: 2384:"A long-range Shh enhancer regulates expression in the developing limb and fin and is associated with preaxial polydactyly" 3573: 4831: 3374: 4534: 3855: 3645: 1608: 1260: 1095: 897:

Early osteotomy and ligament reconstructions should be done to prevent deformities, such as angular growth deformities.

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Ulnar polydactyly usually does not interfere with hand function, but for social reasons it can be treated operatively.

618: 490: 5001: 4720: 4550: 4538: 1580: 1378:, Ryan Dorin plays a pianist with six fingers on each hand who throws his gloves to the audience at the concert's end. 598: 309: 779:

cases with a common articulation or with a sixth metacarpal the muscle executing the abduction of the little finger (

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No surgical outcomes studies exist for evaluating the function of the thumbs after an on-top plasty reconstruction.

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rarely employed in the treatment of congenital thumb duplication. It might be necessary for Wassel types 4, 5, 6.

610: 570: 5006: 2479:"Opposing functions of the ETS factor family define SHH spatial expression in limb buds and underlie polydactyly" 1338: 1315:("Grunkle Ford") has six fingers on both of his hands, a trait which also identifies him in the show's mythology. 999:

frequent in Native American and Asian people. A 1994 study by Finley et al. combined data from Jefferson County,

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Tonkin MA, Bulstrode NW (2007). "Bilhaut-Cloquet procedure for Wassel types III, IV and VII thumb duplication".

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and several syndromes. Polysyndactyly presents various degrees of syndactyly affecting fingers three and four.

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have more, and this is a moderately common condition, especially in certain cat populations. Dogs, like other

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distinctly, as a fully developed finger. Most commonly, the extra finger is rudimentary, consisting of an end

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Lettice LA, Heaney SJ, Purdie LA, Li L, de Beer P, Oostra BA, Goode D, Elgar G, Hill RE, de Graaff E (2003).

296:, a combination of extra and consolidated digits. Other signal transduction pathways in this context are the 4978: 4612: 4589: 3950: 3918: 1365: 1298: 301: 151: 626: 586: 514: 330:

Polydactyly has been linked to the prenatal environment in a 2020 study showing a relationship to maternal

2029:"Six fingers per hand: A congenital additional finger brings motor advantages — Bernstein Center Freiburg" 1693: 289: 167: 4212:

Vaccari, Thomas; Weinstein, Harel; Anderson, Kathryn V.; Lacy, Elizabeth; Selleri, Licia (October 2014).

2383: 1585: 1143:, was born with six fingers on each hand (the extra fingers were surgically removed shortly after birth). 1130:("twenty four" in Spanish), has six fully formed fingers on both hands and six perfect toes on each foot. 4881: 4546: 3461:

Lange, Axel; Müller, Gerd B. (March 1, 2017). "Polydactyly in Development, Inheritance, and Evolution".

2990: 1356: 1104:, a Hong Konger singer and actor nicknamed "Sir One One" (Sir11) as he has six digits on his right hand. 1064: 736: 530: 498: 297: 4214:"ESCRT-II/Vps25 Constrains Digit Number by Endosome-Mediated Selective Modulation of FGF-SHH Signaling" 2222: 5096: 4123: 2927:

Katz K, Linder N (2011). "Postaxial type B polydactyly treated by excision in the neonatal nursery".

2562: 1455: 1120: 1021: 324: 1698: 1392:. Chickens normally have 4 toes on each foot. The chicken breeds known for being polydactyl are the 1111:, Brazil, have six functional fingers on each hand (the thumb is doubled) and six toes on each foot. 4914: 4530: 4403: 4164:"Canine Polydactyl Mutations With Heterogeneous Origin in the Conserved Intronic Sequence of LMBR1" 1485:

developed four toes on each front limb and five toes on each back limb. (For more information, see

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Umair, Muhammad; Ahmad, Farooq; Bilal, Muhammad; Ahmad, Wasim; Alfadhel, Majid (6 November 2018).

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Manske, Paul R. (July 1989). "Treatment of duplicated thumb using a ligamentous/periosteal flap".

2887:(2018) A threshold model for polydactyly. Progress in Biophysics and Molecular Biology 137, 1-11. 4776: 4322: 4281: 4141: 4065: 3574:"Fourteen members of the same family have all got 12 fingers and toes - and put them to good use" 3486: 3447: 3421: 3297: 3254: 3080: 2952: 2586: 2192: 2147: 2010: 1711: 1397: 1146: 667: 320: 2880: 2861: 2359: 1063:, a legendary Portuguese woman who killed seven hiding Castilian soldiers in her oven after the 1684:

Frantz, Charles H.; OʼRahilly, Ronan (December 1961). "Congenital Skeletal Limb Deficiencies".

682: 129: 5111: 5091: 4476: 4436: 4243: 4193: 3890: 3780: 3478: 3413: 3348: 3289: 3246: 3208: 3173: 3134: 3072: 3034: 2978: 2944: 2909: 2884: 2865: 2844: 2817: 2753: 2702: 2661: 2578: 2508: 2459: 2408: 2363: 2342: 2300: 2178: 2139: 2104: 2002: 1994: 1933: 1915: 1873: 1834: 1746: 1666: 1264: 1223:, had an extra finger on each hand which he removed himself during childhood "with the aid of 1060: 1040: 288:

Polydactyly is associated with different mutations, either mutations in a gene itself or in a

70: 3828:"Kentucky's win over Florida 'closed a chapter' for J.J. Weaver: 'It was like he was healed'" 2869: 2367: 1493:

reptiles and amphibians. Polydactyly was a non-pathological, reacquired condition in extinct

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in newborns was approximately 2%, and 10% of these deformities involve the upper extremity.

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As of 2009, 97 genetic syndromes have been associated with different kinds of polydactyly.

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Buck-Gramcko, Dieter (January 2002). "Congenital malformations of the hand and forearm".

1896:"New Notations for Better Morphological Distinction of Postaxial Polydactyly of the Foot" 1074:

was born with six fingers on each hand, the additional fingers being removed after birth.

4127: 3531: 2566: 765: 699: 5037: 4968: 4932: 4904: 4826: 4730: 4604: 4238: 4213: 4188: 4163: 3773: 3440:"'Gemma Arterton's Delicious Extra Fingers - Friday Night with Jonathan Ross - BBC One" 3343: 3316: 2812: 2787: 2748: 2721: 2503: 2478: 2174: 1928: 1895: 1494: 1436: 1420: 1415:

Polydactyly also occurs in dogs, cats, and small mammals such as guinea pigs and mice.

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This article is about the congenital anomaly. For the paleontological application, see

17: 4408: 4027: 3999:"Congenital and Inherited Anomalies of the Musculoskeletal System in Multiple Species" 3969: 3409: 3030: 2338: 2296: 2100: 1975:"Polydactyly of the foot: an analysis of 265 cases and a morphological classification" 1742: 718: 221: 5197: 5047: 4991: 4958: 4841: 4662: 3285: 3242: 3204: 3169: 3130: 2590: 2135: 1990: 1707: 1474: 1307: 1270: 1206: 1202:, an American college football outside linebacker, has six fingers on his right hand. 1133: 566: 518: 284:

Preaxial polydactyly: Ectopic SHH-expression, Hemingway mutant, mouse, right forelimb

202: 4285: 4069: 3301: 3258: 3084: 2956: 2243: 2151: 2014: 1715: 246: 5129: 5022: 4864: 4836: 4622: 4617: 4487: 4145: 3832: 3578: 3490: 3425: 2888: 1199: 231: 155: 3676: 1108: 4430: 4229: 2940: 2574: 2494: 1911: 1649:

McCarroll, H.Relton (November 2000). "Congenital anomalies: A 25-year overview".

5052: 4819: 4695: 4471: 4179: 4055:"Five-toed chickens: their origin, genetics, geographical spreading and history" 3716: 2530: 1502: 1498: 1253: 1114: 659: 4441: 3068: 2974: 1240:

with eight fingers on each hand and about four to five extra toes on each foot.

710:

Classification is performed by using x-ray imaging to see the bone structures.

5027: 4963: 4876: 4870: 4846: 4814: 4781: 4750: 4700: 4672: 3649: 3439: 1830: 1490: 1482: 1193: 1177: 1173: 1167: 663: 662:

with different numbers of toes. The analysis of the additional toe numbers of

634: 630: 546: 542: 480: 269: 265: 57: 3333: 2649: 1998: 1919: 1612: 1517:

Rooster with feathered legs (Aldrovandi himself did not notice the five toes)

1354:

Kinzo Ushiromiya, the head of the Ushiromiya household from the visual novel

5134: 5079: 4886: 4771: 4764: 4745: 4677: 4641: 4482: 4447: 4393: 2738: 2697: 2680: 2636: 1237: 1187: 1050: 4247: 4197: 3482: 3417: 3352: 3250: 3076: 2982: 2948: 2821: 2757: 2706: 2582: 2512: 2463: 2412: 2143: 2108: 1937: 1877: 1838: 1670: 1662: 1054: 3293: 3212: 3177: 3138: 3038: 2848: 2665: 2346: 2304: 2006: 1974: 1750: 4576: 4572: 4554: 3860: 2913: 2444: 2427: 2403: 1894:

Hirota, Yuka; Ueda, Koichi; Umeda, Chizuru; Yoshida, Eriko (2022-11-03).

1729:

Swanson AB (1976). "A classification for congenital limb malformations".

1478: 1463: 1451: 1427:, normally have four claws on their rear paws; a fifth is often called a 654: 476: 319:

of congenital anomalies. When it occurs by itself, it is associated with

316: 4313:

Cooper, John E. (1958). "Some Albino Reptiles and Polydactylous Frogs".

2053:"Six fingers per hand — Office of University and Science Communications" 1952: 1505:, some of which containing upwards of ten digits within their flippers. 722:

Type 1 ulnar polydactyly. An extra digit is attached by skin and nerves.

706:

of type III central polydactyly. The middle fingers are the same length.

188: 5144: 4802: 4344: 4326: 2803: 1869: 1428: 1374: 1220: 1140: 1000: 830: 822:

For infants with ulnar type B polydactyly the recommended treatment is

816: 315:

Polydactyly can occur by itself, or more commonly, as one feature of a

180:

As of 2002, polydactyly has been associated with 39 genetic mutations.

4376: 2900:

Temtamy SA, McKusick VA (1978). "The genetics of hand malformations".

4388: 4136: 4111: 1409: 1224: 585:

Type VII of radial polydactyly is associated with several syndromes:

1853: 3474: 4452: 4356:

Ornithologiae, Ulisse Aldrovandi (ill. Cristoforo Coriolano), 1599

1447: 1443: 1424: 1419:

normally have five digits on the front paws and four on the rear.

1210: 1047:(Spanish for "the Octopus") for his extra digit on each extremity. 1014: 703: 681: 206: 147: 4687: 4419: 4261:

Bauer, Aaron M.; Hathaway, Stacie A.; Fisher, Robert N. (2009).

3272:

Watson BT, Hennrikus WL (1997). "Postaxial type-B polydactyly".

1137: 461: 453: 440: 424: 411: 398: 385: 372: 364: 356: 343: 331: 198: 4503: 3621:"Boxing Champ Danny Garcia Reveals He Has 6 Toes on Right Foot" 2609:

Van Nieuwenhoven C, Boehmer A, Hovius S (2009). "Polydactyly".

2244:"Summary of most common syndromes with concomitant polydactyly" 1196:, an Indian actress, has a rudimentary finger on her left hand. 1149:, High Duke of Poland 1238–1241, had six toes on his left foot. 5120: 4650: 4563: 3646:"Interview Exclusive – Yoandri Hernandez Garrido – 24 fingers" 1611:. University of Maryland Medical Center (UMMC). Archived from 1416: 2122:

Rayan, Ghazi M.; Frey, Bret (May 2001). "Ulnar Polydactyly".

1477:

when they finally began developing a uniform number of toes.

1431:

and is especially found in certain dog breeds, including the

649:

Biased number of polydactylous toes in a Main Coon population

4053:

Corti, Elio; Moiseyeva, Irina G; Romanov, Michael N (2010).

3704:(in Polish). Państwowe Zakłady Wydawn Szkolnych. p. 52. 2681:"Bardet-Biedl syndrome: a rare case report from North India" 1256:, a Chinese calligrapher, had six fingers on his right hand. 644: 511:

ectrodactyly-ectodermal dysplasias-cleft lip/palate syndrome

4032:

University of Illinois Extension: Incubation and Embryology

3856:"Akshat Saxena sets Guinness record for most fingers, toes" 4162:

Park, K; Kang, J; Subedi, Kp; Ha, Jh; Park, C (Aug 2008).

3152:

Dobyns, J. H.; Lipscomb, P. R.; Cooney, W. P. (May 1985).

1180:'s fourth wife, reportedly had six toes on her right foot. 787:. The ulnar collateral ligament and the insertions of the 3594:"Foto revela que Vicente Fox tendría 6 dedos en cada pie" 2224:

Handbook of genetic counseling/polydactyly and syndactyly

541:

Ulnar polydactyly is often bilateral and associated with

1190:

actor born with a supernumerary thumb on his right hand.

1117:, former President of Mexico, has six toes on each foot. 2648:

Nicolai, JP; Hamel, BC; Menalda, GA (27 January 1990).

609:

The syndromes associated with central polydactyly are:

3017:

Light TR (1992). "Treatment of preaxial polydactyly".

1086:, and his brother William had six digits on each limb. 3317:"Clinical Genetics of Polydactyly: An Updated Review" 1469:

Polydactyly is believed to have been common in early

1092:, an African-American poet and civil rights advocate. 1043:, retired MLB professional baseball pitcher known as 201:(little finger) side of the hand, less common on the 4366: 2165:

Jobe MT (2008). "Congenital Anomalies of the Hand".

1854:"Polydactyly: how many disorders and how many genes" 1369:, Leah Nichols was born with 6 fingers on each hand. 1324:, is described many times as "the six-fingered man." 1302:

as part of his cosmetic surgery to disguise himself.

154:

fingers and/or toes. Polydactyly is the opposite of

5167: 5143: 5119: 5110: 5065: 5015: 4977: 4949: 4940: 4931: 4897: 4857: 4801: 4794: 4729: 4686: 4649: 4640: 4603: 4571: 4562: 4545: 4462: 4370: 2720:Panduranga C, Kangle R, Badami R, Patil PV (2012). 2626: 2624: 105: 97: 89: 81: 69: 47: 42: 3933:"Hope for Bangalore girl with 27 fingers and toes" 3772: 2604: 2602: 2600: 2529:. Milton S. Hershey Medical Center. Archived from 2426:Lettice LA, Hill AE, Devenney PS, Hill RE (2008). 1123:, boxing champion, has six toes on his right foot. 629:. Central polydactyly can also be associated with 2455:20.500.11820/76c18e1b-ba87-49c6-9da7-c837187646a5 2283:Graham TJ, Ress AM (1998). "Finger polydactyly". 2889:https://doi.org/10.1016/j.pbiomolbio.2018.04.007 1973:Watanabe, H.; Fujita, S.; Oka, I. (1992-05-01). 960:Ablation with collateral ligament reconstruction 855:Ablation with collateral ligament reconstruction 666:cats revealed that the number of toes follows a 27:Physical anomaly involving extra fingers or toes 4022: 4020: 2977:. Treasure Island (FL): StatPearls Publishing. 2973:Barnes, Curtis J.; De Cicco, Franco L. (2022). 2377: 2375: 2238: 2236: 2234: 1057:are born with more bones, such as six fingers). 769:Left foot with postaxial polydactyly of 5th ray 5209:Congenital disorders of musculoskeletal system 4087:. Whalerock Digital Media, LLC. Archived from 4001:. Merck Sharp & Dohme Corp. Archived from 3802:"Famous people with congenital hand anomalies" 3229:Rayan GM, Frey B (2001). "Ulnar polydactyly". 1900:Plastic and Reconstructive Surgery Global Open 1889: 1887: 1098:, American prodigious math calculating savant. 601:(also known to occur with ulnar polydactyly). 4515: 3911:"Hound Dog Taylor – Everyone Knows the Hound" 3732:"Baby Born With 31 Fingers And Toes In China" 2722:"Meckel-Gruber syndrome: Report of two cases" 1019:Twelve-fingered man, illustrated in the 1493 8: 3752:. Daly City, CA: ABC7 News. January 30, 2009 3373:. University of Pennsylvania. Archived from 2255: 2253: 2216: 2214: 1273:, Turkish national goalkeeper and player of 323:mutations in single genes, i.e. it is not a 65:A left human hand with postaxial polydactyly 4263:"Polydactyly in the Central Pacific Gecko, 3717:"Chinese boy born with 31 fingers and toes" 1083:Vestiges of the Natural History of Creation 5116: 4946: 4937: 4798: 4646: 4568: 4559: 4522: 4508: 4500: 4367: 4034:. University of Illinois Board of Trustees 3506:"Views of Life, Straightforward and Spare" 3158:Clinical Orthopaedics and Related Research 868:elements are centralized and fixed with a 56: 39: 4237: 4187: 4135: 3992: 3990: 3698:Historyczne, Polskie Towarzystwo (1961). 3342: 3332: 3050: 3048: 2968: 2966: 2811: 2747: 2737: 2696: 2502: 2453: 2443: 2402: 2278: 2276: 2274: 1927: 1817:Watt AJ, Chung KC (2009). "Duplication". 1697: 1107:Fourteen members of a Da Silva family in 860:is the more developed one in most cases. 3224: 3222: 1327:Void, an antagonist of the manga series 1259:Reggy B, a drag queen and contestant on 989: 764: 717: 698: 339: 279: 245: 220: 187: 4157: 4155: 3889:. Headline Book Publishing. p. 6. 3554:(in Chinese (Hong Kong)). 11 March 2018 3119:The Journal of Bone & Joint Surgery 2654:Nederlands Tijdschrift voor Geneeskunde 2320: 2318: 2316: 2314: 2082: 2080: 2078: 2076: 2074: 2072: 1812: 1810: 1808: 1806: 1804: 1802: 1800: 1798: 1796: 1794: 1792: 1790: 1788: 1786: 1784: 1782: 1780: 1686:The Journal of Bone & Joint Surgery 1563: 1507: 2999: 2988: 2788:"Legius syndrome in fourteen families" 2679:Kumar S, Mahajan BB, Mittal J (2012). 2200: 2190: 1778: 1776: 1774: 1772: 1770: 1768: 1766: 1764: 1762: 1760: 1553:Muscovy duck, both feet have five toes 1541:Muscovy duck, both feet have five toes 1636:The care of congenital hand anomalies 1489:). Polydactyly also occurs in modern 1481:settled on five toes per limb, while 1231:Theodore Roosevelt "Hound Dog" Taylor 1126:Yoandri Hernández Garrido, nicknamed 475:Because polydactyly can be part of a 7: 5043:Greig cephalopolysyndactyly syndrome 3750:"Baby born with 12 fingers, 12 toes" 3730:Mosbergen, Dominique (May 5, 2016). 691:, and the sixth toe has substantial 551:Greig cephalopolysyndactyly syndrome 3673:"Hamptom Hawes And The Fire Inside" 3572:Myall, Steve (September 16, 2015). 3504:Garner, Dwight (October 11, 2012). 2169:. Vol. 11. pp. 4367–449. 593:(aplastic anemia by the age of 6), 150:and non-human animals resulting in 4533:malformations and deformations of 3854:David W. Freeman (July 25, 2011). 2175:10.1016/b978-0-323-03329-9.50079-9 2124:Plastic and Reconstructive Surgery 1979:Plastic and Reconstructive Surgery 1450:gene. In cattle, it appears to be 93:Lifelong unless surgically removed 25: 3826:Tucker, Kyle (October 15, 2021). 3701:Mowia, wieki: magazyn historyczny 3410:10.2174/1573396314666180124102012 3154:"Management of Thumb Duplication" 2685:Indian J Dermatol Venereol Leprol 2167:Campbell's Operative Orthopaedics 1160:, China, has 31 fingers and toes. 3775:The Private Life of Chairman Mao 3536:. G. and C. Merriam. p. 72. 3450:from the original on 2021-11-17. 3286:10.2106/00004623-199701000-00007 3243:10.1097/00006534-200105000-00021 3170:10.1097/00003086-198505000-00004 3131:10.2106/00004623-198365050-00002 2136:10.1097/00006534-200105000-00021 1991:10.1097/00006534-199205000-00014 1708:10.2106/00004623-196143080-00012 1546: 1534: 1522: 1510: 1404:, Lincolnshire Buff, Meusienne, 1035:Category:People with polydactyly 4716:Congenital patellar dislocation 4595:Wallis–Zieff–Goldblatt syndrome 3463:The Quarterly Review of Biology 1351:, had six fingers on each hand. 1342:, had six fingers on each hand. 1333:, has six fingers on each hand. 1067:, had six fingers on each hand. 489:Examples of syndromes include 142: 'finger'), also known as 3968:Johnston, Lynn (2 July 1986). 3887:Garry Sobers: My Autobiography 3800:Khor, Amy (February 2, 2019). 2902:Birth Defects Orig. Artic. Ser 1487:Polydactyly in early tetrapods 1152:A boy named Hong Hong born in 801:to the retained small finger. 242:Radial or preaxial polydactyly 217:Ulnar or postaxial polydactyly 32:Polydactyly in early tetrapods 1: 3648:. Cubastyletv. Archived from 3100:Congrès Français de Chirurgie 3031:10.1016/S0749-0712(21)00700-9 2870:doi:10.1007/s11692-013-9267-y 2368:doi:10.1007/s11692-013-9267-y 2339:10.1016/s0363-5023(82)80040-3 2297:10.1016/S0749-0712(21)00141-4 2101:10.1016/s1297-3203(02)00103-8 2057:kommunikation.uni-freiburg.de 1953:"Polydactyly (Extra Fingers)" 1743:10.1016/s0363-5023(76)80021-4 1442:A number of mutations of the 334:pollution exposure in China. 166:As of 1977, the incidence of 5204:Autosomal dominant disorders 4230:10.1016/j.celrep.2014.09.019 4110:Fisher, R. A. (March 1950). 4085:"Polydactyly in Guinea Pigs" 3715:Imam, Jareen (May 4, 2016). 3675:. JazzScript. Archived from 3444:OFFICIAL BBC YouTube channel 3205:10.1016/0363-5023(89)90200-1 2941:10.1097/bpo.0b013e31821addb6 2786:Denayer E, Chmara M (2011). 2575:10.1016/j.envres.2020.109643 2527:"Polydactyly and Syndactyly" 2495:10.1016/j.devcel.2011.12.010 1912:10.1097/GOX.0000000000004504 523:oral-facial-digital syndrome 5002:Oto-palato-digital syndrome 4997:Hallermann–Streiff syndrome 4721:Congenital knee dislocation 4539:musculoskeletal abnormality 4267:sp. (Squamata: Gekkonidae)" 4180:10.1534/genetics.108.087114 3193:The Journal of Hand Surgery 2327:The Journal of Hand Surgery 2261:"Pictures of Extra Fingers" 1651:The Journal of Hand Surgery 1581:Online Etymology Dictionary 1336:Zigzag, an antagonist from 1236:Varalakshmi V, a girl from 599:Greig cephalopolysyndactyly 310:zone of polarizing activity 5235: 5033:Craniodiaphyseal dysplasia 3069:10.1016/j.jhse.2007.05.021 2263:(in Dutch). Archived from 1410:non-bearded Silkie Bantams 1032: 575:Smith–Lemli–Opitz syndrome 559:Ellis–van Creveld syndrome 29: 5007:Treacher Collins syndrome 4858:reduction deficits / limb 3970:"Wednesday, July 2, 1986" 3533:A Memoir of Zerah Colburn 3398:Current Pediatric Reviews 1831:10.1016/j.hcl.2009.01.001 1339:The Thief and the Cobbler 1318:Tyrone Rugen, a Count in 846:Bilhaut-Cloquet procedure 641:Polydactyly and evolution 563:McKusick–Kaufman syndrome 527:Rubinstein–Taybi syndrome 503:basal cell nevus syndrome 158:(fewer fingers or toes). 135: 'many' and 64: 55: 5219:Supernumerary body parts 4832:Cenani–Lenz syndactylism 4585:Cleidocranial dysostosis 3334:10.3389/fgene.2018.00447 2432:Human Molecular Genetics 2391:Human Molecular Genetics 1609:"Polydactyly – Overview" 1345:Billy, a character from 1289:The Silence of the Lambs 937:Type B ulnar polydactyly 928:Type A ulnar polydactyly 889:transferred proximally. 805:Type B ulnar polydactyly 774:Type A ulnar polydactyly 672:constructive development 4979:Craniofacial dysostosis 3530:Colburn, Zerah (1833). 2883:, Nemeschkal, Hans L., 2864:, Nemeschkal, Hans L., 2773:Pallister-Hall Syndrome 2739:10.4103/0976-3147.91943 2698:10.4103/0378-6323.93656 2652:[Polydactyly]. 2362:,|Nemeschkal, Hans L., 2033:www.bcf.uni-freiburg.de 1366:For Better or For Worse 1029:People with polydactyly 969:On-top plasty procedure 880:On top plasty procedure 619:Pallister–Hall syndrome 491:Diamond–Blackfan anemia 18:Rudimentary polydactyly 4535:musculoskeletal system 3997:Hanson, DMV, Russell. 2998:Cite journal requires 2726:J Neurosci Rural Pract 2555:Environmental Research 1663:10.1053/jhsu.2000.6457 1466:recessive at another. 1305:In the cartoon series 1080:, purported author of 1025: 995: 799:abductor digiti minimi 794:abductor digiti minimi 789:abductor digiti minimi 785:abductor digiti minimi 781:abductor digiti minimi 770: 723: 707: 696: 650: 595:Townes–Brocks syndrome 290:cis-regulatory element 285: 251: 226: 193: 168:congenital deformities 5087:Klippel–Feil syndrome 4112:"Polydactyly in Mice" 3548:"一山還有一山高蔡一智遇十二指叔叔嗌勁" 3321:Frontiers in Genetics 2975:"Supernumerary Digit" 2771:Biesecker LG (1993). 1852:Biesecker LG (2002). 1357:Umineko When They Cry 1065:Battle of Aljubarrota 1018: 1003:, United States, and 993: 768: 737:Wassel classification 721: 702: 685: 648: 611:Bardet–Biedl syndrome 571:Bardet–Biedl syndrome 531:short rib polydactyly 515:mirror hand deformity 499:acrocallosal syndrome 298:Wnt signaling pathway 283: 249: 225:Postaxial polydactyly 224: 191: 101:Surgery in some cases 5097:Spina bifida occulta 4613:Madelung's deformity 4590:Sprengel's deformity 3939:. September 4, 2010. 3921:on November 6, 2013. 3679:on December 15, 2010 3274:J Bone Joint Surg Am 2611:Praktische Pediatrie 2267:on 11 November 2013. 2089:Chirurgie de la Main 1475:Carboniferous period 1022:Nuremberg Chronicles 994:Preaxial polydactyly 325:multifactorial trait 250:Preaxial polydactyly 4915:RAPADILINO syndrome 4128:1950Natur.165..407F 3771:Li, Zhisui (1994). 3231:Plast Reconstr Surg 2632:Supernumerary Digit 2567:2020ER....187j9643Z 1638:. St. Louis: Mosby. 1607:Kaneshiro, Neil K. 1529:Kitten with 23 toes 1433:Norwegian Lundehund 1244:Volcacius Sedigitus 1227:and a sharp knife". 1205:Akshat Saxena from 1011:Society and culture 977:Central polydactyly 893:Central polydactyly 833:or cyst formation. 744:Central polydactyly 605:Central polydactyly 495:VACTERL association 259:Central polydactyly 146:, is an anomaly in 4777:Rocker bottom foot 4463:External resources 4345:10.1007/bf02987949 4083:Kazmeyer, Milton. 3958:; volume 2, p.214. 3671:Harrison, Dennis. 3510:The New York Times 2804:10.1002/humu.21404 2483:Developmental Cell 2445:10.1093/hmg/ddm370 2404:10.1093/hmg/ddg180 1870:10.1002/ajmg.10779 1615:on 30 October 2012 1588:on October 9, 2016 1321:The Princess Bride 1147:Henry II the Pious 1026: 996: 946:Radial polydactyly 837:Radial polydactyly 771: 731:Radial polydactyly 724: 708: 697: 668:developmental bias 651: 627:Holt–Oram syndrome 587:Holt–Oram syndrome 581:Radial polydactyly 321:autosomal dominant 286: 252: 227: 194: 184:Signs and symptoms 5191: 5190: 5187: 5186: 5183: 5182: 5112:Thoracic skeleton 5092:Spondylolisthesis 5061: 5060: 4927: 4926: 4923: 4922: 4790: 4789: 4636: 4635: 4497: 4496: 4347:. S2CID 85352593. 4274:Herpetology Notes 3937:CitiesMid-Day.com 3896:978-0-7553-1006-7 3786:978-0-679-76443-4 1634:Flatt AE (1977). 1265:Drag Race Holland 1261:the second season 1061:Brites de Almeida 1041:Antonio Alfonseca 951:Bilhaut procedure 923:Ulnar polydactyly 758:Ulnar polydactyly 714:Ulnar polydactyly 693:valgus angulation 537:Ulnar polydactyly 468: 467: 113: 112: 37:Medical condition 16:(Redirected from 5226: 5159:Pectus carinatum 5154:Pectus excavatum 5117: 5075:Spinal curvature 5067:Vertebral column 4987:Crouzon syndrome 4951:Craniosynostosis 4947: 4938: 4803:fingers and toes 4799: 4711:Discoid meniscus 4668:Upington disease 4647: 4569: 4560: 4524: 4517: 4510: 4501: 4368: 4357: 4354: 4348: 4337: 4331: 4330: 4310: 4304: 4303: 4301: 4300: 4294: 4288:. Archived from 4271: 4258: 4252: 4251: 4241: 4208: 4202: 4201: 4191: 4159: 4150: 4149: 4139: 4137:10.1038/165407a0 4107: 4101: 4100: 4098: 4096: 4080: 4074: 4073: 4062:Izvestiya of ТАА 4059: 4050: 4044: 4043: 4041: 4039: 4024: 4015: 4014: 4012: 4010: 3994: 3985: 3984: 3982: 3980: 3974:FBorFW Strip Fix 3965: 3959: 3947: 3941: 3940: 3929: 3923: 3922: 3917:. Archived from 3907: 3901: 3900: 3883:Sobers, Garfield 3879: 3873: 3872: 3870: 3868: 3851: 3845: 3844: 3842: 3840: 3823: 3817: 3816: 3814: 3812: 3797: 3791: 3790: 3779:. Random House. 3778: 3768: 3762: 3761: 3759: 3757: 3746: 3740: 3739: 3727: 3721: 3720: 3712: 3706: 3705: 3695: 3689: 3688: 3686: 3684: 3668: 3662: 3661: 3659: 3657: 3642: 3636: 3635: 3633: 3631: 3616: 3610: 3609: 3607: 3605: 3590: 3584: 3583: 3569: 3563: 3562: 3560: 3559: 3544: 3538: 3537: 3527: 3521: 3520: 3518: 3516: 3501: 3495: 3494: 3458: 3452: 3451: 3436: 3430: 3429: 3393: 3387: 3386: 3384: 3382: 3363: 3357: 3356: 3346: 3336: 3312: 3306: 3305: 3269: 3263: 3262: 3226: 3217: 3216: 3188: 3182: 3181: 3149: 3143: 3142: 3114: 3108: 3107: 3095: 3089: 3088: 3052: 3043: 3042: 3014: 3008: 3007: 3001: 2996: 2994: 2986: 2970: 2961: 2960: 2929:J Pediatr Orthop 2924: 2918: 2917: 2897: 2891: 2878: 2872: 2859: 2853: 2852: 2832: 2826: 2825: 2815: 2783: 2777: 2776: 2768: 2762: 2761: 2751: 2741: 2717: 2711: 2710: 2700: 2676: 2670: 2669: 2645: 2639: 2628: 2619: 2618: 2606: 2595: 2594: 2549: 2543: 2542: 2540: 2538: 2523: 2517: 2516: 2506: 2474: 2468: 2467: 2457: 2447: 2423: 2417: 2416: 2406: 2388: 2379: 2370: 2357: 2351: 2350: 2322: 2309: 2308: 2280: 2269: 2268: 2257: 2248: 2247: 2240: 2229: 2228: 2218: 2209: 2208: 2202: 2198: 2196: 2188: 2162: 2156: 2155: 2130:(6): 1449–1454. 2119: 2113: 2112: 2084: 2067: 2066: 2064: 2063: 2049: 2043: 2042: 2040: 2039: 2025: 2019: 2018: 1970: 1964: 1963: 1961: 1959: 1951:Eaton, Charles. 1948: 1942: 1941: 1931: 1891: 1882: 1881: 1849: 1843: 1842: 1814: 1755: 1754: 1726: 1720: 1719: 1701: 1692:(8): 1202–1224. 1681: 1675: 1674: 1657:(6): 1007–1037. 1646: 1640: 1639: 1631: 1625: 1624: 1622: 1620: 1604: 1598: 1597: 1595: 1593: 1584:. Archived from 1568: 1550: 1538: 1526: 1514: 1281:Fictional people 1154:Pingjiang County 689:varus angulation 507:Biemond syndrome 340: 85:During pregnancy 76:Medical genetics 60: 40: 21: 5234: 5233: 5229: 5228: 5227: 5225: 5224: 5223: 5194: 5193: 5192: 5179: 5175:Poland syndrome 5163: 5139: 5106: 5057: 5011: 4973: 4919: 4910:Larsen syndrome 4898:multiple joints 4893: 4853: 4786: 4725: 4706:Genu recurvatum 4682: 4659:Hip dislocation 4632: 4599: 4549: 4541: 4528: 4498: 4493: 4492: 4458: 4457: 4379: 4365: 4360: 4355: 4351: 4338: 4334: 4312: 4311: 4307: 4298: 4296: 4292: 4269: 4260: 4259: 4255: 4210: 4209: 4205: 4161: 4160: 4153: 4109: 4108: 4104: 4094: 4092: 4082: 4081: 4077: 4057: 4052: 4051: 4047: 4037: 4035: 4026: 4025: 4018: 4008: 4006: 3996: 3995: 3988: 3978: 3976: 3967: 3966: 3962: 3956:Pliny the Elder 3951:Natural History 3948: 3944: 3931: 3930: 3926: 3909: 3908: 3904: 3897: 3885:(May 1, 2002). 3881: 3880: 3876: 3866: 3864: 3853: 3852: 3848: 3838: 3836: 3825: 3824: 3820: 3810: 3808: 3799: 3798: 3794: 3787: 3770: 3769: 3765: 3755: 3753: 3748: 3747: 3743: 3729: 3728: 3724: 3714: 3713: 3709: 3697: 3696: 3692: 3682: 3680: 3670: 3669: 3665: 3655: 3653: 3644: 3643: 3639: 3629: 3627: 3625:Bleacher Report 3618: 3617: 3613: 3603: 3601: 3592: 3591: 3587: 3571: 3570: 3566: 3557: 3555: 3546: 3545: 3541: 3529: 3528: 3524: 3514: 3512: 3503: 3502: 3498: 3460: 3459: 3455: 3438: 3437: 3433: 3395: 3394: 3390: 3380: 3378: 3377:on 27 July 2011 3365: 3364: 3360: 3314: 3313: 3309: 3271: 3270: 3266: 3228: 3227: 3220: 3190: 3189: 3185: 3151: 3150: 3146: 3116: 3115: 3111: 3097: 3096: 3092: 3057:J Hand Surg Eur 3054: 3053: 3046: 3016: 3015: 3011: 2997: 2987: 2972: 2971: 2964: 2926: 2925: 2921: 2899: 2898: 2894: 2885:Müller, Gerd B. 2879: 2875: 2866:Müller, Gerd B. 2860: 2856: 2834: 2833: 2829: 2785: 2784: 2780: 2770: 2769: 2765: 2719: 2718: 2714: 2678: 2677: 2673: 2647: 2646: 2642: 2629: 2622: 2608: 2607: 2598: 2551: 2550: 2546: 2536: 2534: 2525: 2524: 2520: 2476: 2475: 2471: 2425: 2424: 2420: 2397:(14): 1725–35. 2386: 2381: 2380: 2373: 2364:Müller, Gerd B. 2358: 2354: 2324: 2323: 2312: 2282: 2281: 2272: 2259: 2258: 2251: 2242: 2241: 2232: 2220: 2219: 2212: 2199: 2189: 2185: 2164: 2163: 2159: 2121: 2120: 2116: 2086: 2085: 2070: 2061: 2059: 2051: 2050: 2046: 2037: 2035: 2027: 2026: 2022: 1972: 1971: 1967: 1957: 1955: 1950: 1949: 1945: 1893: 1892: 1885: 1851: 1850: 1846: 1816: 1815: 1758: 1728: 1727: 1723: 1699:10.1.1.975.8614 1683: 1682: 1678: 1648: 1647: 1643: 1633: 1632: 1628: 1618: 1616: 1606: 1605: 1601: 1591: 1589: 1570: 1569: 1565: 1561: 1554: 1551: 1542: 1539: 1530: 1527: 1518: 1515: 1495:marine reptiles 1421:Polydactyl cats 1385: 1294:Hannibal Lecter 1283: 1217:Garfield Sobers 1090:Lucille Clifton 1078:Robert Chambers 1037: 1031: 1013: 988: 979: 971: 962: 953: 948: 939: 930: 925: 920: 911: 895: 882: 857: 848: 839: 812:suture ligation 807: 776: 760: 755: 746: 733: 716: 680: 643: 623:Legius syndrome 615:Meckel syndrome 607: 583: 555:Meckel syndrome 539: 473: 337:Types include: 278: 261: 244: 219: 186: 164: 38: 35: 28: 23: 22: 15: 12: 11: 5: 5232: 5230: 5222: 5221: 5216: 5211: 5206: 5196: 5195: 5189: 5188: 5185: 5184: 5181: 5180: 5178: 5177: 5171: 5169: 5165: 5164: 5162: 5161: 5156: 5150: 5148: 5141: 5140: 5138: 5137: 5132: 5126: 5124: 5114: 5108: 5107: 5105: 5104: 5099: 5094: 5089: 5084: 5083: 5082: 5071: 5069: 5063: 5062: 5059: 5058: 5056: 5055: 5050: 5045: 5040: 5038:Dolichocephaly 5035: 5030: 5025: 5019: 5017: 5013: 5012: 5010: 5009: 5004: 4999: 4994: 4989: 4983: 4981: 4975: 4974: 4972: 4971: 4969:Trigonocephaly 4966: 4961: 4955: 4953: 4944: 4942:Skull and face 4935: 4929: 4928: 4925: 4924: 4921: 4920: 4918: 4917: 4912: 4907: 4905:Arthrogryposis 4901: 4899: 4895: 4894: 4892: 4891: 4890: 4889: 4884: 4879: 4867: 4861: 4859: 4855: 4854: 4852: 4851: 4850: 4849: 4839: 4834: 4829: 4827:Arachnodactyly 4824: 4823: 4822: 4807: 4805: 4796: 4792: 4791: 4788: 4787: 4785: 4784: 4779: 4774: 4769: 4768: 4767: 4755: 4754: 4753: 4748: 4735: 4733: 4731:foot deformity 4727: 4726: 4724: 4723: 4718: 4713: 4708: 4703: 4698: 4692: 4690: 4684: 4683: 4681: 4680: 4675: 4670: 4665: 4655: 4653: 4644: 4638: 4637: 4634: 4633: 4631: 4630: 4625: 4620: 4615: 4609: 4607: 4605:hand deformity 4601: 4600: 4598: 4597: 4592: 4587: 4581: 4579: 4566: 4557: 4543: 4542: 4529: 4527: 4526: 4519: 4512: 4504: 4495: 4494: 4491: 4490: 4479: 4467: 4466: 4464: 4460: 4459: 4456: 4455: 4444: 4433: 4422: 4411: 4396: 4380: 4375: 4374: 4372: 4371:Classification 4364: 4363:External links 4361: 4359: 4358: 4349: 4332: 4305: 4265:Lepidodactylus 4253: 4224:(2): 674–687. 4203: 4174:(4): 2163–72. 4151: 4102: 4075: 4064:(7): 156–170. 4045: 4028:"Chicken Feet" 4016: 3986: 3960: 3942: 3924: 3902: 3895: 3874: 3846: 3818: 3792: 3785: 3763: 3741: 3722: 3707: 3690: 3663: 3637: 3611: 3585: 3564: 3539: 3522: 3496: 3475:10.1086/690841 3453: 3431: 3388: 3358: 3307: 3264: 3237:(6): 1449–54. 3218: 3199:(4): 728–733. 3183: 3164:(195): 26–44. 3144: 3125:(5): 584–598. 3109: 3090: 3044: 3009: 3000:|journal= 2962: 2919: 2892: 2873: 2854: 2827: 2798:(1): 1985–98. 2778: 2763: 2712: 2671: 2650:"Polydactylie" 2640: 2620: 2596: 2544: 2518: 2469: 2418: 2371: 2352: 2333:(5): 460–465. 2310: 2270: 2249: 2230: 2210: 2201:|journal= 2183: 2157: 2114: 2068: 2044: 2020: 1985:(5): 856–877. 1965: 1943: 1883: 1858:Am J Med Genet 1844: 1825:(2): 215–227. 1756: 1731:J Hand Surg Am 1721: 1676: 1641: 1626: 1599: 1562: 1560: 1557: 1556: 1555: 1552: 1545: 1543: 1540: 1533: 1531: 1528: 1521: 1519: 1516: 1509: 1437:Great Pyrenees 1390:chicken breeds 1384: 1381: 1380: 1379: 1370: 1361: 1352: 1348:Adventure Time 1343: 1334: 1325: 1316: 1313:Stanford Pines 1303: 1282: 1279: 1278: 1277: 1268: 1257: 1251: 1241: 1234: 1228: 1219:, West Indian 1214: 1203: 1197: 1191: 1184:Hrithik Roshan 1181: 1171: 1164: 1161: 1158:Hunan province 1150: 1144: 1131: 1124: 1118: 1112: 1105: 1099: 1093: 1087: 1075: 1072:Gemma Arterton 1068: 1058: 1048: 1030: 1027: 1012: 1009: 1005:Uppsala County 987: 984: 978: 975: 970: 967: 961: 958: 952: 949: 947: 944: 938: 935: 929: 926: 924: 921: 919: 916: 910: 907: 894: 891: 881: 878: 870:Kirschner wire 856: 853: 847: 844: 838: 835: 806: 803: 775: 772: 759: 756: 754: 751: 745: 742: 732: 729: 715: 712: 679: 676: 642: 639: 606: 603: 591:Fanconi anemia 582: 579: 538: 535: 472: 469: 466: 465: 459: 456: 450: 449: 446: 443: 437: 436: 430: 427: 421: 420: 417: 414: 408: 407: 404: 401: 395: 394: 393:19p13.2-p13.1 391: 388: 382: 381: 378: 375: 369: 368: 362: 359: 353: 352: 349: 346: 294:synpolydactyly 277: 274: 260: 257: 243: 240: 218: 215: 185: 182: 163: 160: 111: 110: 107: 103: 102: 99: 95: 94: 91: 87: 86: 83: 79: 78: 73: 67: 66: 62: 61: 53: 52: 49: 45: 44: 36: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 5231: 5220: 5217: 5215: 5212: 5210: 5207: 5205: 5202: 5201: 5199: 5176: 5173: 5172: 5170: 5166: 5160: 5157: 5155: 5152: 5151: 5149: 5146: 5142: 5136: 5133: 5131: 5128: 5127: 5125: 5122: 5118: 5115: 5113: 5109: 5103: 5102:Sacralization 5100: 5098: 5095: 5093: 5090: 5088: 5085: 5081: 5078: 5077: 5076: 5073: 5072: 5070: 5068: 5064: 5054: 5051: 5049: 5048:Plagiocephaly 5046: 5044: 5041: 5039: 5036: 5034: 5031: 5029: 5026: 5024: 5021: 5020: 5018: 5014: 5008: 5005: 5003: 5000: 4998: 4995: 4993: 4992:Hypertelorism 4990: 4988: 4985: 4984: 4982: 4980: 4976: 4970: 4967: 4965: 4962: 4960: 4959:Scaphocephaly 4957: 4956: 4954: 4952: 4948: 4945: 4943: 4939: 4936: 4934: 4930: 4916: 4913: 4911: 4908: 4906: 4903: 4902: 4900: 4896: 4888: 4885: 4883: 4880: 4878: 4875: 4874: 4873: 4872: 4868: 4866: 4863: 4862: 4860: 4856: 4848: 4845: 4844: 4843: 4842:Brachydactyly 4840: 4838: 4835: 4833: 4830: 4828: 4825: 4821: 4818: 4817: 4816: 4812: 4809: 4808: 4806: 4804: 4800: 4797: 4795:Either / both 4793: 4783: 4780: 4778: 4775: 4773: 4770: 4766: 4763: 4762: 4761: 4760: 4756: 4752: 4749: 4747: 4744: 4743: 4742: 4741: 4737: 4736: 4734: 4732: 4728: 4722: 4719: 4717: 4714: 4712: 4709: 4707: 4704: 4702: 4699: 4697: 4694: 4693: 4691: 4689: 4685: 4679: 4676: 4674: 4671: 4669: 4666: 4664: 4663:Hip dysplasia 4660: 4657: 4656: 4654: 4652: 4648: 4645: 4643: 4639: 4629: 4626: 4624: 4621: 4619: 4616: 4614: 4611: 4610: 4608: 4606: 4602: 4596: 4593: 4591: 4588: 4586: 4583: 4582: 4580: 4578: 4574: 4570: 4567: 4565: 4561: 4558: 4556: 4552: 4548: 4544: 4540: 4536: 4532: 4525: 4520: 4518: 4513: 4511: 4506: 4505: 4502: 4489: 4485: 4484: 4480: 4478: 4474: 4473: 4469: 4468: 4465: 4461: 4454: 4450: 4449: 4445: 4443: 4439: 4438: 4434: 4432: 4428: 4427: 4423: 4421: 4417: 4416: 4412: 4410: 4406: 4405: 4401: 4397: 4395: 4391: 4390: 4386: 4382: 4381: 4378: 4373: 4369: 4362: 4353: 4350: 4346: 4342: 4336: 4333: 4328: 4324: 4320: 4316: 4315:Herpetologica 4309: 4306: 4295:on 2017-08-11 4291: 4287: 4283: 4279: 4275: 4268: 4266: 4257: 4254: 4249: 4245: 4240: 4235: 4231: 4227: 4223: 4219: 4215: 4207: 4204: 4199: 4195: 4190: 4185: 4181: 4177: 4173: 4169: 4165: 4158: 4156: 4152: 4147: 4143: 4138: 4133: 4129: 4125: 4122:(4193): 407. 4121: 4117: 4113: 4106: 4103: 4091:on 2018-04-09 4090: 4086: 4079: 4076: 4071: 4067: 4063: 4056: 4049: 4046: 4033: 4029: 4023: 4021: 4017: 4005:on 2017-07-31 4004: 4000: 3993: 3991: 3987: 3975: 3971: 3964: 3961: 3957: 3953: 3952: 3946: 3943: 3938: 3934: 3928: 3925: 3920: 3916: 3915:TheDeltaBlues 3912: 3906: 3903: 3898: 3892: 3888: 3884: 3878: 3875: 3863: 3862: 3857: 3850: 3847: 3835: 3834: 3829: 3822: 3819: 3807: 3803: 3796: 3793: 3788: 3782: 3777: 3776: 3767: 3764: 3751: 3745: 3742: 3737: 3733: 3726: 3723: 3718: 3711: 3708: 3703: 3702: 3694: 3691: 3678: 3674: 3667: 3664: 3652:on 2014-07-29 3651: 3647: 3641: 3638: 3626: 3622: 3619:Carson, Dan. 3615: 3612: 3600:. 7 June 2021 3599: 3595: 3589: 3586: 3581: 3580: 3575: 3568: 3565: 3553: 3549: 3543: 3540: 3535: 3534: 3526: 3523: 3511: 3507: 3500: 3497: 3492: 3488: 3484: 3480: 3476: 3472: 3468: 3464: 3457: 3454: 3449: 3445: 3441: 3435: 3432: 3427: 3423: 3419: 3415: 3411: 3407: 3403: 3399: 3392: 3389: 3376: 3372: 3371:Penn Medicine 3368: 3367:"Polydactyly" 3362: 3359: 3354: 3350: 3345: 3340: 3335: 3330: 3326: 3322: 3318: 3311: 3308: 3303: 3299: 3295: 3291: 3287: 3283: 3279: 3275: 3268: 3265: 3260: 3256: 3252: 3248: 3244: 3240: 3236: 3232: 3225: 3223: 3219: 3214: 3210: 3206: 3202: 3198: 3194: 3187: 3184: 3179: 3175: 3171: 3167: 3163: 3159: 3155: 3148: 3145: 3140: 3136: 3132: 3128: 3124: 3120: 3113: 3110: 3105: 3102:(in French). 3101: 3094: 3091: 3086: 3082: 3078: 3074: 3070: 3066: 3063:(6): 684–93. 3062: 3058: 3051: 3049: 3045: 3040: 3036: 3032: 3028: 3025:(1): 161–75. 3024: 3020: 3013: 3010: 3005: 2992: 2984: 2980: 2976: 2969: 2967: 2963: 2958: 2954: 2950: 2946: 2942: 2938: 2934: 2930: 2923: 2920: 2915: 2911: 2907: 2903: 2896: 2893: 2890: 2886: 2882: 2877: 2874: 2871: 2867: 2863: 2858: 2855: 2850: 2846: 2842: 2838: 2831: 2828: 2823: 2819: 2814: 2809: 2805: 2801: 2797: 2793: 2789: 2782: 2779: 2774: 2767: 2764: 2759: 2755: 2750: 2745: 2740: 2735: 2731: 2727: 2723: 2716: 2713: 2708: 2704: 2699: 2694: 2690: 2686: 2682: 2675: 2672: 2667: 2663: 2659: 2655: 2651: 2644: 2641: 2638: 2634: 2633: 2627: 2625: 2621: 2616: 2612: 2605: 2603: 2601: 2597: 2592: 2588: 2584: 2580: 2576: 2572: 2568: 2564: 2560: 2556: 2548: 2545: 2533:on 2010-03-07 2532: 2528: 2522: 2519: 2514: 2510: 2505: 2500: 2496: 2492: 2489:(2): 459–67. 2488: 2484: 2480: 2473: 2470: 2465: 2461: 2456: 2451: 2446: 2441: 2438:(7): 978–85. 2437: 2433: 2429: 2422: 2419: 2414: 2410: 2405: 2400: 2396: 2392: 2385: 2378: 2376: 2372: 2369: 2365: 2361: 2356: 2353: 2348: 2344: 2340: 2336: 2332: 2328: 2321: 2319: 2317: 2315: 2311: 2306: 2302: 2298: 2294: 2290: 2286: 2279: 2277: 2275: 2271: 2266: 2262: 2256: 2254: 2250: 2245: 2239: 2237: 2235: 2231: 2226: 2225: 2217: 2215: 2211: 2206: 2194: 2186: 2184:9780323033299 2180: 2176: 2172: 2168: 2161: 2158: 2153: 2149: 2145: 2141: 2137: 2133: 2129: 2125: 2118: 2115: 2110: 2106: 2102: 2098: 2095:(2): 70–101. 2094: 2090: 2083: 2081: 2079: 2077: 2075: 2073: 2069: 2058: 2054: 2048: 2045: 2034: 2030: 2024: 2021: 2016: 2012: 2008: 2004: 2000: 1996: 1992: 1988: 1984: 1980: 1976: 1969: 1966: 1954: 1947: 1944: 1939: 1935: 1930: 1925: 1921: 1917: 1913: 1909: 1906:(11): e4504. 1905: 1901: 1897: 1890: 1888: 1884: 1879: 1875: 1871: 1867: 1864:(3): 279–83. 1863: 1859: 1855: 1848: 1845: 1840: 1836: 1832: 1828: 1824: 1820: 1813: 1811: 1809: 1807: 1805: 1803: 1801: 1799: 1797: 1795: 1793: 1791: 1789: 1787: 1785: 1783: 1781: 1779: 1777: 1775: 1773: 1771: 1769: 1767: 1765: 1763: 1761: 1757: 1752: 1748: 1744: 1740: 1736: 1732: 1725: 1722: 1717: 1713: 1709: 1705: 1700: 1695: 1691: 1687: 1680: 1677: 1672: 1668: 1664: 1660: 1656: 1652: 1645: 1642: 1637: 1630: 1627: 1614: 1610: 1603: 1600: 1587: 1583: 1582: 1577: 1575: 1567: 1564: 1558: 1549: 1544: 1537: 1532: 1525: 1520: 1513: 1508: 1506: 1504: 1503:hupehsuchians 1500: 1496: 1492: 1488: 1484: 1480: 1476: 1472: 1467: 1465: 1461: 1457: 1453: 1449: 1445: 1440: 1438: 1434: 1430: 1426: 1422: 1418: 1413: 1411: 1407: 1403: 1399: 1395: 1391: 1383:Other animals 1382: 1377: 1376: 1371: 1368: 1367: 1362: 1359: 1358: 1353: 1350: 1349: 1344: 1341: 1340: 1335: 1332: 1331: 1326: 1323: 1322: 1317: 1314: 1310: 1309: 1308:Gravity Falls 1304: 1301: 1300: 1295: 1291: 1290: 1285: 1284: 1280: 1276: 1272: 1269: 1266: 1262: 1258: 1255: 1252: 1249: 1245: 1242: 1239: 1235: 1232: 1229: 1226: 1222: 1218: 1215: 1212: 1208: 1207:Uttar Pradesh 1204: 1201: 1198: 1195: 1192: 1189: 1185: 1182: 1179: 1175: 1172: 1169: 1165: 1162: 1159: 1155: 1151: 1148: 1145: 1142: 1139: 1135: 1134:Hampton Hawes 1132: 1129: 1125: 1122: 1119: 1116: 1113: 1110: 1106: 1103: 1100: 1097: 1096:Zerah Colburn 1094: 1091: 1088: 1085: 1084: 1079: 1076: 1073: 1069: 1066: 1062: 1059: 1056: 1052: 1049: 1046: 1042: 1039: 1038: 1036: 1028: 1024: 1023: 1017: 1010: 1008: 1006: 1002: 992: 985: 983: 976: 974: 968: 966: 959: 957: 950: 945: 943: 936: 934: 927: 922: 917: 915: 909:Complications 908: 906: 902: 898: 892: 890: 886: 879: 877: 873: 871: 865: 861: 854: 852: 845: 843: 836: 834: 832: 827: 825: 820: 818: 813: 804: 802: 800: 795: 790: 786: 782: 773: 767: 763: 757: 752: 750: 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