Triphalangeal thumb with polydactyly: an alternative surgical method.

Area of Science:

• Congenital Hand Surgery
• Pediatric Orthopedics
• Hand Surgery

Background:

• Triphalangeal thumb (TPT) is a congenital hand anomaly characterized by three phalanges, often resulting in diminished thumb strength and function.
• Thumb appearance in TPT can vary, including increased length or radial/ulnar deviation, impacting overall hand functionality.
• Surgical goals for TPT include normalizing length, improving function, joint stability, and thumb positioning.

Purpose of the Study:

• To present an alternative surgical technique for treating Triphalangeal thumb (TPT) with pre-axial polydactyly.
• To describe the transfer of a functioning interphalangeal (IP) joint from a rudimentary thumb to a TPT with limited joint mobility.

Main Methods:

• The study details a case of TPT with pre-axial polydactyly where the TPT lacked proximal and distal interphalangeal joint mobility.
• A functioning interphalangeal (IP) joint from a rudimentary thumb was identified as a potential source for reconstruction.
• Surgical planning involved transferring this viable IP joint to enhance the TPT's functionality.

Main Results:

• The TPT presented with three phalanges but lacked active movement at its interphalangeal joints.
• A co-existing rudimentary thumb possessed a well-developed and functional interphalangeal (IP) joint.
• The proposed surgical method aimed to utilize this functioning IP joint to restore mobility to the TPT.

Conclusions:

• This case highlights a unique surgical approach for TPT, particularly when associated with limited joint function.
• Transferring a functioning IP joint from a rudimentary thumb offers a potential solution for improving TPT mobility and function.
• This technique addresses the functional deficit in TPT by reconstructing a mobile joint.