Van der Zwaag et al. (2010) studied a 27-month-old boy who was born with bilateral postaxial polydactyly of the hands. The extra sixth digits, which were removed surgically, consisted of soft tissue only, although a nail was present ... Van der Zwaag et al. (2010) studied a 27-month-old boy who was born with bilateral postaxial polydactyly of the hands. The extra sixth digits, which were removed surgically, consisted of soft tissue only, although a nail was present on the left sixth digit. In addition, the boy had an anteriorly placed anus, with remnants of a spontaneously ruptured anal membrane that was treated with dilation only. Examination at 8 months of age showed macrocephaly and mild facial dysmorphism, including broad nasal bridge, telecanthus, and frontal bossing; his ears were slightly rotated and had small lobules, with a left-sided preauricular tag. At 27 months of age, he had normal psychomotor development and persistent but nonprogressive macrocephaly. The parents, who were a nonconsanguineous Caucasian and Africo-South American couple, were normocephalic. A half brother of the proband's mother was reported by family history to have had polydactyly of both hands and feet; he died at 4 days of age, but the cause of death was unknown.