Related Experiment Video
Updated: Mar 13, 2026

Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
[Preaxial polydactyly of the hand: 15 years of experience]
Y D Pacheco1, C Lorca-García1, B Berenguer1
1Sección de Cirugía Plástica Infantil. Hospital General Universitario Gregorio Marañón. Madrid.
Insights
Early surgical treatment for preaxial polydactyly (thumb duplication) yields good functional and aesthetic outcomes. Preservation of the dominant thumb is the preferred surgical approach, with minimal complications like clinodactyly.
Area of Science:
- Hand surgery
- Congenital malformations
- Pediatric orthopedics
Background:
- Preaxial polydactyly is a common congenital hand malformation.
- Optimal treatment involves early surgical intervention between 6 and 12 months of age.
- This study reviews surgical outcomes for thumb duplication.
Purpose of the Study:
- To review casuistry, treatment, and outcomes of thumb duplication.
- To evaluate functional and aesthetic results of surgical interventions.
- To analyze data from 2000 to the present.
Main Methods:
- Retrospective study of patients diagnosed with preaxial polydactyly (2000-2016).
- Analysis of patient demographics, surgical techniques, and postoperative results.
- Classification of polydactyly using Wassel and Tada systems.
Main Results:
- 30 cases of thumb duplication and 31 bifid thumbs diagnosed.
- Wassel type IV and II were most common; right hand most affected.
- 83.8% good postoperative results (Tada system); 5 cases of radial clinodactyly.
Conclusions:
- Preaxial polydactyly is common, typically unilateral, with no gender predilection.
- Surgical treatment, primarily preserving the dominant thumb, yields good results.
- Radial clinodactyly is the most frequent complication, mainly aesthetic.
Introduction:
Preaxial polydactyly is one of the most common congenital malformations of the hand. The treatment is surgical and should be done early, between 6 and 12 months old. The purpose of this paper is to review our experience in terms of casuistry, treatment and functional and aesthetic results of duplicity of thumb, since 2000 until today.
Material And Methods:
A retrospective study of patients with diagnosis of preaxial polydactyly from 2000 to january 2016 was performed.
Results:
Thirty patients with duplicity of thumb and thirty one bifid thumbs were diagnosed. No difference was found in terms of gender. The right hand was the most affected. Wassel type IV was the most common, followed by type II. Age at time of surgery had a median and mode of 12 months. All were treated surgically, using the model of preservation of the dominant thumb in 97% of the cases. According to Tada system, our postoperative results were good in 26 cases (83.8%). Our most frequent complication was slight radial clinodactyly, which was found in 5 cases.
Conclusions:
Preaxial polydactyly of the hand is one of the most common congenital malformations. It is usually unilateral and without gender predominance. Surgical treatment provides good results. The most common technique for reconstruction is the model of preservation of the dominant thumb. Clinodactyly is the most common complication after surgery, however its presence is more aesthetic than a functional problem.
More Related Videos
Related Concept Videos
Muscles of the Forearm that Move the Hand and Fingers
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi...
Bones of the Upper Limb: Radius
The radius has a nail-shaped head, and a...
Spinal Nerves: Plexus I
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
Bones of the Upper Limb: Ulna
Pleiotropy
Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...

