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Polydactyly and the triphalangeal thumb

V E Wood

    The Journal of Hand Surgery
    |September 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Polydactyly with triphalangeal thumb is a common congenital upper extremity deformity. Early surgical intervention, including digit removal and reconstruction, is crucial for optimal hand function and avoiding complications.

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    Area of Science:

    • Orthopedics
    • Pediatric Surgery
    • Hand Surgery
    • Congenital Hand Deformities

    Background:

    • Polydactyly, the presence of extra digits, is a frequent congenital anomaly.
    • Triphalangeal thumb, characterized by three phalanges instead of two, can occur with polydactyly.
    • This combined condition, polydactyly with triphalangeal thumb, represents a significant subset of upper extremity congenital deformities.

    Purpose of the Study:

    • To analyze the incidence and classification of polydactyly associated with triphalangeal thumb.
    • To detail the recommended early surgical management strategies for this condition.
    • To emphasize the importance of comprehensive treatment for functional outcomes.

    Main Methods:

    • Review of 1,269 patient records with congenital upper extremity deformities.

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  • Identification and classification of cases exhibiting polydactyly and triphalangeal thumb using Wassel's system.
  • Analysis of treatment approaches, including surgical techniques and post-operative considerations.

    • Main Results:

    • Twenty-one patients (32 hands) presented with polydactyly associated with triphalangeal thumb.
    • Classification based on Wassel's criteria was applied to these cases.
    • Surgical interventions involved digit removal, accessory part excision (including delta bone), ligament reconstruction or fusion, and osteotomy.

    Conclusions:

    • Polydactyly with triphalangeal thumb is a notable congenital hand difference requiring early and precise surgical management.
    • Effective treatment necessitates addressing all aberrant structures, including accessory digits and potential delta bones.
    • Careful reconstruction and prevention of first web space narrowing are vital for achieving optimal hand function.