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. 2023 Jan 20:10:2333794X221149828.
doi: 10.1177/2333794X221149828. eCollection 2023.

Thumb Duplication Surgical Treatment: Outcomes and Results

Maria Pia Monjardino  1 , Marcos Carvalho  1 , Pedro Sá Cardoso  1 , Tah Pu Ling  1 , Cristina Alves  1
Affiliations

Thumb Duplication Surgical Treatment: Outcomes and Results

Maria Pia Monjardino et al. Glob Pediatr Health. .

Abstract

Aim: This study aims to evaluate functional and esthetic outcomes of thumb duplication correction in pediatric age.

Methods: Retrospective study including all pediatric patients with thumb duplication undergoing surgical treatment between 2012 and 2017. We analyzed demographic data, surgical technique, and surgical outcomes considering Tada, Horii, and Tien scores, according to the following parameters: active mobility of the metacarpophalangeal and interphalangeal joints, stability, alignment, and family's opinion about cosmetic and function of the thumb. The Wassel-Flatt classification was used to classify the duplicated thumbs.

Results: A total of 11 patients were included, predominantly male (ratio 1.8:1), with a median age at time of surgery of 19[10-26] months and a median follow-up time after surgery of 23 [3-63] months. The Wassel- Flatt type IV thumb was the most frequent (73%). The postoperative evaluation revealed that 82% of patients had good results in Tada score, 73% had good results in Horii score, and all patients showed good results in Tien score. We found a relation between lower age and fair postoperative alignment (P = .047) and between fair postoperative alignment and fair final Tada (P = .022), Horii (P = .006), and Tien (P = .009) scores.

Conclusions: Excision and reconstruction procedures are good options in the treatment of thumb duplication providing good clinical results, with excellent parent satisfaction. Timing of surgery is important for favorable esthetic outcomes, while angular deformity is a determining factor that for postoperative dissatisfaction.

Keywords: functional and aesthetic outcomes; paediatric; surgery; thumb duplication.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Photograph demonstrating a thumb duplication (Wassel-Flatt type V), with a hypoplastic radial thumb.
Figure 2.
Figure 2.
Pre and post-operative appearance of a patient where simple excision of the radial thumb was performed.
Figure 3.
Figure 3.
(A) Pre and postoperative appearance of a Wassel-Flatt type IV pre-axial duplication submitted to an excision of the radial hypoplastic thumb, extra metacarpal facet excision, capsular reefing, radial collateral ligament reconstruction, and abductor pollicis brevis reinsertion. (B) Pre and postoperative radiological view of the thumb.
See this image and copyright information in PMC

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References

    1. Rogers BH, Schmieg SL, Pehnke ME, Shah AS. Evaluation and management of preaxial polydactyly. Curr Rev Musculoskelet Med. 2020;13(4):545-551. doi:10.1007/s12178-020-09644-w - DOI - PMC - PubMed
    1. Goldfarb CA, Shaw N, Steffen JA, Wall LB. The prevalence of congenital hand and upper extremity anomalies based upon the New York congenital malformations registry. J Pediatr Orthop. 2017;37(2):144-148. doi:10.1097/BPO.0000000000000748 - DOI - PMC - PubMed
    1. Wassel HD. The results of surgery for polydactyly of the thumb. A review. Clin Orthop. 1969;64:175-193. - PubMed
    1. Cabrera González M, Pérez López LM, Martínez Soto G, Gutiérrez de la Iglesia D. Prognostic value of age and Wassel classification in the reconstruction of thumb duplication. J Child Orthop. 2013;7(6):551-557. doi:10.1007/s11832-013-0534-3 - DOI - PMC - PubMed
    1. Comer GC, Potter M, Ladd AL. Polydactyly of the hand. J Am Acad Orthop Surg. 2018;26(3):75-82. doi:10.5435/JAAOS-D-16-00139 - DOI - PubMed

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