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Reconstruction for Wassel type III radial polydactyly with two digits equal in size
Emiko Horii1, Tatsuya Hattori, Syukuki Koh
1Nagoya 1st Red Cross Hospital, Nagoya, Japan. emikoh@med.nagoya-u.ac.jp
The Journal of Hand Surgery
|November 10, 2009
Summary
Surgical outcomes for Wassel type III radial polydactyly were evaluated. Excising the radial thumb with augmentation yielded good functional results, with improved thumb width and acceptable cosmetic appearance.
Area of Science:
- Orthopedic Surgery
- Pediatric Hand Surgery
- Congenital Hand Anomalies
Background:
- Radial polydactyly is a congenital condition involving thumb duplication.
- Wassel type III describes cases with duplicated digits of equal or near-equal size.
- Surgical management aims to improve thumb function and aesthetics.
Purpose of the Study:
- To report surgical outcomes for Wassel type III radial polydactyly.
- To evaluate a technique involving radial thumb excision with augmentation.
- To assess functional and cosmetic results in pediatric patients.
Main Methods:
- Reconstruction of 15 Wassel type III cases with equally sized digits.
- Ablation of the radial digit while preserving the distal articular surface.
- Augmentation via tendon repositioning, collateral ligament restoration, and soft tissue transfer.
Main Results:
- Average functional score of 12/14 points.
- Increased distal phalanx width from 62% to 78% of metacarpal size.
- Average cosmetic score of 3.6/4, with acceptable nail appearance.
Conclusions:
- The described surgical technique provides functionally good outcomes for Wassel type III radial polydactyly.
- Potential disadvantages include minor interphalangeal joint motion restriction and extension lag.
