Polydactyly, or duplication of fingers, is another common congenital deformity seen in the hand. It is most often seen at the level of the thumb in which there is a duplicated small thumb appendage emanating from the radial border of the metacarpal phalangeal joint, i.e., the main joint within the thumb. Surgical treatment includes the ablation or the removal of the remnant of the small duplicate portion of the thumb and reconstruction of the ligamentous structures around the joint to stabilize this joint and give the patient full function. This is often done at an early age, i.e., after one year of age, and before the child begins school. Most pediatric procedures should be delayed until after one year of age. This is such that there is a significant decrease in possible complications from anesthesia due to the development of the heart, lungs and liver which are important in excretion of the anesthetics.