Synpolydactyly of the hand: A radiographic classification

L. B. Wall, D. S. Bae, S. N. Oishi, R. P. Calfee, C. A. Goldfarb

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Synpolydactyly is an uncommon congenital anomaly characterized by polydactyly with syndactyly in the central hand. The purpose of this investigation was to develop and assess the reliability of a radiographic classification system for synpolydactyly. We identified 56 hands with central synpolydactyly and developed a radiographic classification system that categorizes by the location within the hand, the bony level of polydactyly, and the presence of a delta phalanx. Four paediatric hand surgeons independently reviewed each radiograph to establish reliability. There was exact agreement among raters in 40 cases (71%). The inter-rater reliability was 0.97 and intra-rater reliability was at least 0.87. Seven of 16 bilateral cases had symmetric deformity classification. The most common presentations were types 1A and 2A. We present a new, reliable radiographic classification system for synpolydactyly that will allow improved communication between clinicians and serve as a foundation for future investigations.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalJournal of Hand Surgery: European Volume
Issue number3
StatePublished - Mar 1 2016


  • Polydactyly
  • classification
  • radiograph
  • reliability
  • syndactyly


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