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Radial polydactyly: towards a unifying approach for surgical management
Tian Xiaofei1,2,3, Wee L Lam4,5, Shanlin Chen6,7
1Department of Burns and Plastic Surgery, Children's Hospital of Chongqing Medical University, China.
The Journal of Hand Surgery, European Volume
|June 29, 2026
Summary
A new classification simplifies radial polydactyly surgical planning. This approach addresses complex cases, improving functional and aesthetic outcomes for thumb reconstruction.
Area of Science:
- Hand Surgery
- Pediatric Orthopedics
- Congenital Hand Anomalies
Background:
- Radial polydactyly presents complex surgical challenges, often leading to suboptimal outcomes.
- Existing classifications inadequately address soft-tissue anomalies and bony deviations.
- Increased patient expectations demand greater surgical precision for aesthetic symmetry.
Purpose of the Study:
- To introduce a simplified, two-group classification for radial polydactyly.
- To guide surgical strategy by integrating key anatomical and morphological factors.
- To improve functional and aesthetic results in thumb reconstruction.
Main Methods:
- Developed a classification based on decades of clinical experience.
- Integrated factors: size discrepancy, axis deviation, soft-tissue quality, nail deformity.
- Incorporated transverse and longitudinal reconstructive concepts, including modified Bilhaut-Cloquet and on-top plasty.
Main Results:
- The proposed classification addresses at least 95% of radial polydactyly cases.
- Provides a structured approach for surgical planning and communication.
- Facilitates tailored reconstruction based on anatomical complexity.
Conclusions:
- This pragmatic classification offers an intuitive framework for clinical use.
- Aligning complexity with tailored reconstruction leads to more consistent outcomes.
- Enhances functional and aesthetic results in radial polydactyly management.
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