Central Ray Synpolydactyly with Bilateral Medial Foot Polydactyly and Hydrocephalus: A Case Report.

Central ray synpolydactyly is a rare congenital anomaly that presents complex surgical challenges due to the combined presence of digit duplication and fusion. Early recognition and appropriate management are essential to preserve hand function and appearance. This case report describes the successful single-stage surgical management of a 3-year-old girl with right central ray synpolydactyly, a rare congenital hand anomaly combining features of polydactyly and syndactyly. The patient presented with an extra digit on the ulnar side of the middle finger, complete syndactyly with the middle finger, and incomplete syndactyly with the ring finger. Surgical correction involved excision of the extra digit and reconstruction of the third web space using an M-V flap, minimizing the need for skin grafting. Postoperative recovery was uneventful, with no complications, and at the 6-month follow-up, the patient demonstrated a full range of motion, functional independence, and a well-healed scar. This report highlighted the effectiveness of meticulous surgical planning and the M-V flap technique in achieving optimal functional and aesthetic outcomes in central ray synpolydactyly.