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Sri Lanka Pictures Ceylon, ශ්‍රී ලංකා

Ulnar or postaxial polydactyly

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 distinctly, as a fully developed finger. Most commonly, the extra finger is rudimentary, consisting of an end phalanx with a nail, 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 negroid ethnicities and is most common 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 and African Americans. 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. In almost 14% of all patients, this type of polydactyly is hereditary. It usually passes on in an autosomal dominant manner with variable expression and incomplete penetrance. It is genetically heterogenic, meaning that mutations in different genes can be the cause. When the extra digit is pedicled it can be very movable; however, injuries are rare and have never been reported so far (Wikipedia)