If a subject has more than 10 fingers, as occasionally happens, the
thumbs and the next 4 fingers to them should be printed, and any
fingers left over should be printed on the other side of the card with
a notation made to the effect that they are extra fingers. When a
person with more than 10 fingers has an intentional amputation
performed, it is invariably the extra finger on the little finger side
which is amputated.
It also happens, not infrequently, that a subject will have two or
more fingers webbed or grown together, as in figures 383 and 384,
making it impossible to roll such fingers on the inside. Such fingers
should be rolled, however, as completely as possible, and a notation
made to the effect that they are joined.
Split thumbs, i.e., thumbs having two nail joints, as in figure 385,
are classified as if the joint toward the outside of the hand were not
present. In other words the inner joint is used, and no consideration
whatever is given to the outer joint.