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What is polydactyly? Actor David Tennant talks about the rare, generic condition and his six toes

Scottish actor and returning BAFTA Film Awards host David Tennant has confirmed he has an extra toe, after keen-eyed super-fans noticed something unusual.

In a recent interview with Metro, the former Doctor Who star was asked about the speculation circulating on Reddit regarding an extra digit, and whether there was any truth to it.

The 53-year-old actor confirmed that the rumours were accurate, explaining that he has six toes on one foot. In the interview, Tennant described it as a “sort of like a nubbin” on the little toe side of his right foot.

Having extra fingers or toes is caused by a birth defect called polydactyly. Polydactyly means “many fingers (or toes)” in Greek, and it is one of the most common congenital limb differences in newborn children, according to the Hospital for Special Surgery.

So, what exactly is polydactyly, and what causes it?

David Tennant has six toes on one foot
David Tennant has six toes on one foot

What is polydactyly? “Polydactyly is a congenital, and sometimes inherited condition, where a child is born with additional digits, be it a hand or a foot,” explains Miss Jurga Pikturnaite, a consultant specialising in plastic reconstructive, hand and aesthetic surgery.

“The extra digits can occur on any number of limbs in the one individual and there can be more than one extra digit on one limb.

“The condition can be isolated or be a part of a genetic syndrome/ sequence.”

There are three main types of polydactyly, classed on where on the limb the extra digit occurs.

“Pre-axial is when the extra digits are on the side of the thumb or the great toe, whereas post-axial is when the extra digits are on the side where the small finger or little toe are (a fairly common condition),” says the surgeon.

And the third type is central, which is when the extra digits form in the middle of the hand or foot, which is very rare, according to Pikturnaite.

“These extra digits are usually smaller, less developed and can range from a little pedunculated structure, to a – much-less frequently – fully developed digit,” notes Pikturnaite.

In many cases, polydactyly is not a cause for concern either functionally or physiologically
In many cases, polydactyly is not a cause for concern either functionally or physiologically

What causes it? “Polydactyly can either be inherited via the autosomal dominant pathway, which means only one parent needs to pass on the gene for the condition to appear, or can occur due to environmental factors and abnormalities during foetal development,” explains Pikturnaite.

“While polydactyly is relatively rare, it is one of the most common congenital limb differences that we see.

“It affects as many as 1 in 500-1,000 live births.”

Polydactyly is either inherited or can occur because of issues in the womb
Polydactyly is either inherited or can occur because of issues in the womb

How can it impact someone’s everyday life? Babies who are born with the condition are usually assessed by a team of experts.

“In many cases, polydactyly is not a cause for concern either functionally or physiologically, however this should only be determined after a newborn has been assessed by a congenital limb differences’ team,” says Pikturnaite.

“This is usually a multidisciplinary team including a congenital hand surgeon, a paediatrician, a specialist nurse, a play specialist, a geneticist, a psychologist and several other specialists.”

Additional digits which are small and non-functional tend not to cause any functional issues and only need a simple surgical correction if desired by the family, adds the surgeon.

“When the extra digit is fully formed, it could equally not cause any difficulties, however sometimes can interfere with the use of the limb (hand dexterity, including writing or walking) and even something as simple as the fitting of a shoe as the child grows,” notes Pikturnaite.

Polydactyly means “many fingers (or toes)” in Greek
Polydactyly means “many fingers (or toes)” in Greek

How is it diagnosed? “Polydactyly is usually diagnosed at birth, however can also be seen on antenatal scans provided a good view is possible to obtain while scanning a wriggly foetus in the mother’s womb,” says Pikturnaite.

“At birth, a physical examination usually reveals the additional digits.

“Where further visualisation of the internal structure of the digit and surrounding structures is needed, an X-ray can be helpful.”

David Tennant is returning to host the BAFTA Film Awards next weekend
David Tennant is returning to host the BAFTA Film Awards next weekend

Is surgery recommended? The decision to proceed with surgery is one that rests with the child’s family.

“Simple cases of uncomplicated post-axial polydactyly only ever need the extra digit removing, with the children then leading a perfectly normal life with an excellent function,” says Pikturnaite. “However, I have met families who prefer to keep the extra digit and consider it to be their lucky charm or even family’s pride.

“It is important to respect their views and wishes, especially as simple polydactyly often has no relevance to one’s function and the aesthetic appearance of a limb is very much a personal preference of each individual.”

However, in more complicated cases, such as with pre-axial or central polydactyly, surgical treatment is usually advised and follow ups are made.

“In these cases, children are followed up to maturity to ensure the limb is developing in line with the rest of the child and surgical corrections are made as and when required,” explains Pikturnaite. “We do this to ensure the children are not hindered by their limb differences in achieving their developmental milestones and forming their social interactions.”

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