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Living with Guttmacher syndrome

An extremely rare syndrome with small thumbs and big toes, extra little fingers, short second toes, and hypospadias.

Understanding Guttmacher syndrome

Guttmacher syndrome is an extremely rare syndrome with differences in the thumbs, fingers, toes, and the urethra opening.

People have small thumbs and big toes, a short and curved fifth finger, extra little fingers (postaxial polydactyly), short second toes with absent nails, and hypospadias, in which the urethra opens on the underside of the penis. It is noticed in the newborn period or infancy.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Extra little finger
  • Short thumb
  • Short fifth finger
  • Short second toe
  • Hypospadias

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include bone and joint specialists, genetic specialists and urinary and male reproductive system specialists.

  3. Consider genetic testing

    Changes in HOXA13 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Bone and joint specialists (orthopedists or orthopedic surgeons); Genetic specialists (geneticists); Urinary and male reproductive system specialists (urologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with rare disease patient organizations for support
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Can genetic testing confirm a change in the HOXA13 gene?
Does hypospadias need surgery, and when?
Which hand or foot specialists should be involved?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Dominant
GenesHOXA13

Changes in the HOXA13 gene cause this condition. It is inherited in an autosomal dominant way, which means one changed copy of the gene is enough.

GeneticUrinary and Reproductive

Also known as: preaxial deficiency-postaxial polydactyly-hypospadias syndrome; preaxial deficiency, postaxial polydactyly, hypospadias syndrome

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Guttmacher syndromeGARD ID 4470 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Guttmacher syndrome.

Explore the Guttmacher syndrome blog

Explore research for Guttmacher syndrome

Explore actively recruiting Guttmacher syndrome studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Guttmacher syndrome with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
  • Share your city to look for research near you
  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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