Neglected bilateral triphalangeal of the thumb delta type in adult case: A case report

In rare case, thumb has extra phalanges known as triphalangeal of the thumb (TPT). Patients with TPT can have difficulty doing work/activities that require high precision. Therefore, surgical intervention is essential. This report provides an approach for a patient with TPT.

A patient with TPT who underwent removal of extra phalanges and arthrodesis of interphalangeal (IP) joints is presented. The left thumb deviated 25^o to ulnar while the contralateral part deviated 15^o to radial. X-ray revealed both thumbs had extra delta-shaped middle phalanges. Complete excision of extra phalanges and simple arthrodesis of IP joints with two K-wires in 10° to 15° flexion was performed. Healing process ended without any complications and the patient had an improvement.

Productive-age patients with TPT can have difficulty doing work and activities that require high precision, especially in the non-opposable type of the right hand. Furthermore, the female patient is highly emphasizing the cosmetics of her hand to increase her self-confidence. Therefore, surgical intervention is essential for this patient. We performed complete excision of extra phalanges and simple arthrodesis of IP joints with two K-wires in 10° to 20° flexion. The first K-wire is introduced intramedullary as a primary fixator for longitudinal alignment, and the second wire is inserted obliquely as an anti-rotation wire. Functional outcome was assessed after 6 months post-removal of the wire which gave a satisfying result.

TPT is a rare anomaly which surgical intervention can improve the appearance and the precision of the hand.