Historically, the treatment for central polydactyly describes a dorsal surgical approach with wedge excision of the central digits, potentially resulting in sub-optimal correction with persistent widening of the foot. With the technique of advancement flaps, plantar and dorsal skin flaps through a mid-medial incision provide exposure for resection of the central rays. Following reconstruction of the transverse metatarsal ligament, excess skin is resected and the skin flaps are closed providing a skin tether to maintain a normally narrow foot. The procedure is demonstrated in a one -year -old male with right foot central polydactyly.
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