Paul of Aegina lived in a era when the preservation of the ancient Greek tradition was for him almost a necessity. Eager to follow the dogma of "oρθoπo(ε)δώ" (orthopodo: pace with no malformation), he introduced a series of surgical operations of reconstructive-cosmetic-plastic-orthopaedic nature to confront any disfiguration of the human body. The aim of our study is to present the atmosphere of the era concerning the congenital malformations, describe briefly Paul's contribution on classic orthopaedics and present his views on the preternatural fingers. Our methodology mainly included the indexing of Paul's treatise, as published by the Sydenham Society during the nineteenth century, while references from the ancient Greek scholars were added to compose a better understanding of Paul's views. Inside his seven book treatise "Medical Compendium", he dedicated a separate chapter "On preternatural fingers, and on persons having six fingers", to introduce a detailed description of the extremities' additional digits and propose surgical treatment for their correction. He classified polydactylism according both to the presence of bones and to the anatomical origin of each additional finger. Paul marked the beginning of a new era for orthopaedics.
Keywords: Byzantium; Cosmetic-plastic surgery; Orthopaedics; Paul of Aegina; Polydactylism; Preternatural fingers.