Clinical Presentation, Surgical Treatment, and Outcome in Radial Polydactyly

Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deut
Robert R DijkmanWiebke Hülsemann

Abstract

Radial polydactyly or 'thumb duplication' is the most common congenital upper limb anomaly ('CULA') affecting the thumb. The clinical presentation is highly diverse, ranging from an extra thumb floating on a skin bridge to complicated thumb triplications with triphalangeal, deviating, and hypoplastic components. Radial polydactyly can be classified into one of 7 osseous presentations using the Wassel classification, with type IV (45%), type II (20%), and type VII (15%) occurring most frequently. When faced with a radial polydactyly case, hand surgeons specialised in congenital anomalies must weigh the preoperative functional potential and degree of hypoplasia of both thumbs in order to decide whether to resect one thumb and reconstruct the other ('resection and reconstruction'), excise a central part of both thumbs and unite the lateral tissues into one thumb ('the Bilhaut procedure'), transfer the better-developed distal tissues of one thumb onto the better-developed proximal tissues of the other ('on-top plasty'), or discard both severely hypoplastic thumbs and pollicise the index finger. Mere excision of the hypoplastic thumb is rarely indicated since it often requires subsequent revision surgery. Even after being treated by...Continue Reading

Citations

Jan 9, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Garet C ComerAmy L Ladd
Jan 10, 2018·Hand : Official Journal of the American Association for Hand Surgery·Brian P KelleyKevin C Chung
Sep 19, 2018·The Journal of Hand Surgery, European Volume·Steven E R HoviusChristianne A van Nieuwenhoven
May 20, 2016·Neonatal Network : NN·Marie Claire Farrugia, Jean Calleja-Agius
Dec 1, 2018·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Zisis KyriazisZoe H Dailiana
Feb 1, 2020·Case Reports in Plastic Surgery & Hand Surgery·Michael Finsterwald, Sebastian Guenkel
Jan 15, 2021·The Journal of Hand Surgery, European Volume·Xia FangBin Wang

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