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Review
. 2016 Nov;30(4):181-188.
doi: 10.1055/s-0036-1593736.

The Duplicated Thumb: A Review

Renae D Van Wyhe  1 , Jeffrey G Trost  1 , John C Koshy  1 , William C Pederson  1
Affiliations
Review

The Duplicated Thumb: A Review

Renae D Van Wyhe et al. Semin Plast Surg. 2016 Nov.

Abstract

Preaxial polydactyly is a common, often sporadic, congenital anomaly that must be addressed surgically early in life. Ideally, the surgeon seeks to accomplish three goals: construction of a thumb that is adequate in size, preservation of pinch function, and reconstruction of all components in one procedure. Although each case is unique, several classification systems attempt to describe the various types. In this article, the authors discuss the various classification systems, procedures, and outcomes after surgery for pediatric thumb duplication.

Keywords: Bilhaut-Cloquet procedure; ablation; preaxial polydactyly; reconstruction; thumb duplication; wassel classification.

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Figures

Fig. 1
Fig. 1
(A) Wassel Type II duplication, dorsal view, (B) Wassel Type II duplication, palmar view, (C) X-ray showing duplicated distal phalanx.
Fig. 2
Fig. 2
(A) Wassel Type IV duplication, dorsal view. (B) Wassel type IV duplication, volar view. (C) X-ray showing duplication of proximal and distal phalanges.
Fig. 3
Fig. 3
(A) Wassel II duplication showing markings for excision and reconstruction. (B) Thumb after resection of radial digit and reconstruction. Note interdigitating flaps rather than straight-line scar.
Fig. 4
Fig. 4
“Unbalanced” Wassel type IV duplication. These can be difficult to reconstruct due to the angulation and instability of both interphalangeal joints.
Fig. 5
Fig. 5
Thumb one year after reconstruction of type IV duplication.
Fig. 6
Fig. 6
(A, B) Hands of child 6 years status post bilateral Wassel type IV duplication reconstruction. Thumbs are stable and functional. Note mild hypoplasia and somewhat prominent metacarpophalangeal joint due to broad metacarpal head. (C) Postoperative X-ray showing reasonable alignment. Again note somewhat broad metacarpal head.
See this image and copyright information in PMC

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