The animal loving Diana Muldaur had just bought a house in the Pacific Palisades when she learned that she had gotten the lead in Born Free.
Born Free is one of the greatest shows of the seventies and a must for everyone who loves animals and nature. The incidence of congenital deformities in newborns is approximately 2%, and 10% of these deformities involve the upper extremity. Because there is an association between polydactyly and several syndromes, children with a congenital upper extremity deformity should be examined by a geneticist for other congenital anomalies. Research has shown that the majority of congenital anomalies occur during the 4-week embryologic period of rapid limb development. 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.
When the extra digit is pedicled it can be very movable; however, injuries are rare and have never been reported so far.
This is a very rare situation, in which the extra digit is on the ring, middle or index finger. This type of polydactyly can be associated with syndactyly, cleft hand and several syndromes. Polydactyly is associated with different mutations, either mutations in a gene itself or in a cis-regulatory element+ responsible for the expression of a specific gene.
In the specific case of preaxial polydactyly (Hemingway mutant), a cis-acting mutation approximately 1Mb upstream of Shh gene has been implicated. In addition to the study of genetic causes of polydactyly limb patterning models are used to simulate the congenital disorder+ at the limb, being able to explain the development paths of polydactyly. Polydactyly can occur by itself, or more commonly, as one feature of a syndrome+ of congenital anomalies. Ulnar polydactyly is often bilateral and associated with syndactyly+ and polydactyly of the feet.
Holt–Oram syndrome+, Fanconi anemia+ (aplastic anemia by the age of 6), Townes–Brocks syndrome+, and Greig cephalopolysyndactyly+ (also known to occur with ulnar polydactyly). The Wassel classification+ is the most widely used classification of radial polydactyly, based upon the most proximal level of skeletal duplication. 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 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. Ulnar polydactyly usually does not interfere with hand function, but for social reasons it can be treated operatively.
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.
In patients with a common metacarpal articulation an elliptical incision at the base of the post-axial digit is made.
In patients with a duplicated metacarpal, the accessory digit is amputated in a standard ray fashion with transfer of the abductor digiti minimi to the retained small finger. The pedicled ulnar extra digit can be removed by suture ligation to devise the skin bridge of the newborn child. For infants with ulnar type B polydactyly the recommended treatment is ligation in the neonatal nursery.
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.
This type of procedure is recommended for Wassel types 1 and 2 (in which both thumbs are severely hypoplastic) by some congenital hand surgeons.
This type of procedure is used for all Wassel types of polydactyly and is the most commonly used technique. 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. Elevation of the APB and FPB is performed in Wassel type 4 duplication; this can be accomplished via the periosteum or separately. In Wassel type 5 and 6 the opponens pollicis muscle must be transferred to the ulnar metacarpal. This type is indicated when one thumb is larger proximally and the other thumb has a larger distal component. At the level of the mid-proximal phalanx or mid-metacarpal, the distal component is transferred to the proximal component. Early osteotomy and ligament reconstructions should be done to prevent deformities, such as angular growth deformities.
There are no substantive outcome studies regarding the function of these hands following surgical intervention. However, no investigators have objectively reviewed functional range of motion or articular stability. 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 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. The average IP flexion in a reconstructed thumb is 55 degrees less than the contralateral thumb.
Although surgeons try to obtain a stable thumb of appropriate size, instability of the IP and MCP joint may occur, as well as a size mismatch.
No surgical outcomes studies exist for evaluating the function of the thumbs after an on-top plasty reconstruction.
However, several primary factors contribute to the complexity of central polydactyly reconstruction.
A number of mutations of the LMBR1+ gene, in dogs, humans, and mice, can cause polydactyly. Polydactyly was believed to be common in the earliest tetrapods+, the number of digits settling to the common five on each foot in amniotes+ and four to the hand and five to the foot in amphibians+ in the early Carboniferous+; for more information, see Polydactyly in early tetrapods+.
Polydactyly+ Polydactyly or polydactylism (from Greek ????? (polys), meaning "many", and ???????? (daktylos), meaning "finger"), also known as hyperdactyly, is a congenital physical anomaly in humans, dogs, and cats having supernumerary fingers or toes. The series was based on  Joy Adamson's books about her and her husband's lives as game wardens in East Africa.

Congenital anomalies of the limb can be classified in seven categories, proposed by Frantz and O’Rahilly and modified by Swanson, based on the embryonic failure causing the clinical presentation.
This should also be done if a syndrome is suspected, or if more than two or three generations of the family are affected.
It usually passes on in an autosomal dominant manner with variable expression and incomplete penetrance. Radial polydactyly refers to the presence of an extra digit (or extra digits) on the radial side of the hand.
Thumb polydactyly varies from barely visible broadening of the distal phalanx to full duplication of the thumb including the first metacarpal. Of these fingers, the index finger is most often affected, whereas the ring finger is rarely affected. Normally Shh is expressed in an organiser region, called the zone of polarizing activity+ (ZPA) on the posterior limb side. When it occurs by itself, it is associated with autosomal dominant+ mutations in single genes, i.e.
When the duplicated proximal phalanx articulates with a common, broad metacarpal head, the ulnar collateral ligament must be considered. This incision may be extended proximally in order to adequately expose the abductor digiti minimi. The surgical technique is analogous to radial polydactyly, in which the level of duplication and anatomical components should guide operative treatment. This might be easier than an excision of the extra digit when the child is 6 to 12 months old.
Studies have shown that excision of the extra digit in the neonatal nursery is a safe and simple procedure with a good clinical and cosmetic outcome. Instead of amputating the most hypoplastic thumb, preservation of skin, nail, collateral ligaments and tendons is needed to augment the residual thumb.
It is recommended in all cases of thumb duplication with a hypoplastic, less-functional thumb.
As the tendons insert proximally, the elevation is performed proximally too to potentially rebalance the ulnar thumb. Soft tissue with collateral ligament reconstruction is used to avoid any angular deformity in the preserved thumb.
The tendons of the distal component are preserved as the rest of the distal component is amputated. The incision is favored toward the accessory digit, preserving extra skin for subsequent closure. This is mainly caused by the fact that there is a generally normal function of these patients’ hands following ablation with collateral ligament reconstruction. 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 6 months of age or older. Furthermore, the IP and MCP joints are very stable as the collateral ligaments are not violated during reconstruction.
MCP flection averaged 55 degrees in reconstructed thumbs, compared to 75 degrees in the contralateral thumb. Also, it preserves the nail bed and physis, this increases the prevention of nail deformities over time. 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. Tada and colleagues note that satisfactory surgical correction of central polydactyly is difficult to achieve and that outcomes are generally poor.
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. Postaxial hand polydactyly is a common isolated disorder in African black children, and autosomal dominant transmission is suspected.
He was born in 2010 with 7 digits on each hand and 10 digits on each foot, for a total of 34 digits. However, considering that this rumour first emerged in the 1580s from a Catholic dissenter, it is generally deemed false.
The royal coat of arms of the Hungarian kings is decorated with a six-fingered hand in Stephan's honour. Mixed Human-Chieri offspring and families resulting from such pairing are among the most important protagonists of the series (some inheriting the six-fingered hands of their ancestors).
His burnt corpse was later found and identified by the presence of the extra digit on his foot. A Schubert+ Impromptu+ was altered so it can only be played by a person with six digits in each hand.
One of the main characters, a young girl called Sophie, keeps secret the fact that she has six toes on each foot. Monk spends much of the run of the series searching for a six-fingered man who was involved in the bombing. In it, the character Kogan Iwamoto, Grandmaster of the Kogan-Ryuu Dojo, has six fingers on his right hand. Devastated by the abnormal features of the baby, Grigory is reluctant to have it baptized, calling the baby "a confusion of nature." The baby dies of thrush in its early infancy. Polydactyl cat+s have more, and this is a moderately common condition, especially in certain cat populations. Polydactyly in early tetrapods+ Polydactyly in early tetrapods should here be understood as having more than five digits to the finger or foot, a condition that was the natural state of affairs in the very first tetrapods. Occasionally it contains bone without joints; rarely it may be a complete functioning digit. These categories are failure of formation of parts, failure of differentiation, duplication, overgrowth, undergrowth, congenital constriction band syndrome, and generalized skeletal abnormalities.
More specific loci and genetic mechanisms responsible for disorders of duplications will be defined with time, as molecular research continues. 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. It is most frequent in Indian populations and it is the second most common congenital hand disorder.
Interactions of Hoxd13 and GLI3 induce synpolydactyly+, a combination of extra and consolidated digits. Ulnar polydactyly occurs as an isolated congenital condition, but can also be part of a syndrome. In type A there is an extra little finger at the metacarpophalangeal joint, or more proximal including the carpometacarpal joint.

In those cases with a common articulation or with a sixth metacarpal the muscle executing the abduction of the little finger (abductor digiti minimi) must be preserved. The ulnar collateral ligament and the insertions of the abductor digiti minimi are then elevated with a periosteal sleeve.
Ligation occludes the vascular supply to the duplicated digit, resulting in dry gangrene and subsequent autoamputation.
Surgery is recommended in the first year of life, generally between 9 and 15 months of age. After the radial thumb is amputated, the ulnar elements are centralized and fixed with a Kirschner wire+.
On top plasty procedure is rarely employed in the treatment of congenital thumb duplication. The neurovascular bundle which supplies the distal component is reserved and transferred proximally.
Depending on the level and extent of duplication, the flexor and extensor tendons may require centralization or rebalancing. Also, thumb size one-third greater or less than the contralateral thumb is defined as unacceptable.
Therefore, treatment is wholly dependent on the anatomic components present, the degree of syndactyly, and the function of the duplicated finger.
Postaxial polydactyly is more frequent in native Africans living in the Eastern and Central than the Caucasians and Mongoloids and is more frequent in male children.
Naipaul's ''A House for Mr Biswas+'', the title character Mohun Biswas is born with an extra finger, considered a bad omen. The extra digit is most common on the ulna+r (little finger) side of the hand, less common on the radial+ (thumb+) side, and very rarely within the middle three digits. 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. In the mutant, smaller ectopic expression in a new organiser region is seen on the posterior side of the limb.
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. This must be done with consideration of the presence of a neurovascular bundle, even in very small skin bridges. In most cases, a longitudinal and sagittal osteotomy is needed to centralize the bony parts of the ulnar thumb. The surgeon must also consider whether retention of a fully functional supranumerary digit is preferable to surgical intervention. All patients required secondary surgical procedures to address flexion contractures and angular deviation at the IP joint level. In contrast, postaxial polydactyly seen in white children is usually syndromic and associated with an autosomal recessive transmission.
Polydactyl cat+ A polydactyl cat is a cat with a congenital physical anomaly called polydactyly (or polydactylism, also known as hyperdactyly), that causes the cat to be born with more than the usual number of toes on one or more of its paws. These are respectively known as postaxial (little finger), preaxial (thumb), and central (ring, middle, index fingers) polydactyly. Mostly one neurovascular bundle can be identified, with no tendons present in the extra digit. This ectopic expression causes cell proliferation delivering the raw material for one or more new digits. Typically the mutated gene is involved in developmental patterning, and a syndrome of congenital anomalies results, of which polydactyly is one feature or two. If the width of the nail bed is greater than 70% of the contralateral thumb, it may be split. 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.
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. Wide articular surfaces should be narrowed and phalangeal wedge osteotomies may be required to provide an axial alignment. 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. In case of a fully developed extra finger, the duplication usually presents itself at the level of the metacarpophalangeal joint. 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. At last the collateral ligament and abductor digiti minimi are reinserted at the base of the preserved proximal phalanx and a wire is then placed across the reconstructed joint. The APB and FPB of the ablated radial thumb are attached to the distal phalanx for more stability.
An excision can prevent the development of a residual nubbin and the sensibility due to a neuroma. If necessary, the extensor pollicis longus and the flexor pollicis longus are reattached to centralize their course.
When magazines list "The greatest moments in television history", Rosalind Shay's name usually turns up.
Ulnar polydactyly occurs ten times more often in negroid ethnicities and is most common in African populations. Polydactylus+ Polydactylus is a genus of threadfin native to the Indian, Atlantic, and Pacific Oceans. 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.
This website is a tribute to Diana Muldaur, Rosalind Shays and all the other characters Diana's played. In patients with African ancestry ulnar polydactyly mostly occurs isolated, whereas the presentation in Caucasians is often associated with a syndrome. Found in tropical to subtropical waters throughout the world, the threadfin family contains nine genera and 33 species.
Atlantic threadfin+ The Atlantic threadfin, Polydactylus octonemus, is a threadfin native to subtropical and temperate waters of the western Atlantic Ocean and the Gulf of Mexico.

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