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Triplicated thumbs: a rarity?

J M Zuidam1, M Ananta, S E R Hovius

  • 1Department of Plastic and Reconstructive Surgery, Erasmus Medical Centre Rotterdam, The Netherlands. j.zuidam@erasmusmc.nl

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|September 8, 2007
PubMed
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Triplication of the thumb, a complex radial polydactyly, appears more common than previously thought, especially in a specific Dutch genetic isolate. Surgical reconstruction aims to create a functional thumb from available elements.

Area of Science:

  • Orthopedics
  • Medical Genetics
  • Developmental Biology

Background:

  • Radial polydactyly is a congenital limb malformation.
  • Thumb triplication is considered a rare and complex subtype.

Observation:

  • A high incidence of triplicated thumbs was observed in a Dutch cohort.
  • Eleven cases of triplicated thumbs, associated with triphalangeal components, were identified in 9 patients with radial polydactyly.

Findings:

  • Triplicated thumbs are not as rare as previously reported, particularly in a genetic isolate in the southwest Netherlands linked to chromosome 7q36.
  • Existing classifications inadequately describe the observed triplicated thumb variations.
  • Surgical treatment involved excising aberrant rays, osteotomies for alignment, joint stabilization, tendon reinsertion, and correction of triphalangeal components.

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Implications:

  • The findings suggest a need to re-evaluate the prevalence of thumb triplication.
  • Understanding the genetic basis (chromosome 7q36) may aid in diagnosis and genetic counseling.
  • Surgical principles for complex radial polydactyly are effective in reconstructing functional thumbs.