It is a congenital condition in which a child has two thumbs (an extra digit on radial side of hand).
Wassell’s classification
Type I: bifid distal phalanx (2%), Type II: duplicated distal phalanx (15%)
Type III: bifid proximal phalanx with duplicated distal phalanx (6%)
Type IV: duplicated proximal and distal phalanx (43%)
Type V: bifid metacarpal with duplicated proximal and distal phalanx (10%)
Type VI: duplicated metacarpal, proximal and distal phalanx (4%)
Type VII: triphalangeal thumb accompanied by a normal thumb (20%).
Removing one duplicate and reconstructing the other. – For types III and IV, or types I and II with significant asymmetry. The radial duplicate is usually proximal and smaller than the ulnar. – Radial collateral ligaments should be reconstructed Sharing equal parts of each and removing adjacent inner halves of each duplicate (The Bilhaut-Cloquet procedure).
Outcome depends on the location and size of the fistula and status of surrounding tissues. Although most of the fistula closes after the surgery, some may recur and requires further surgery.
It usually takes less time than the original hypospadias repair and completes in less than an hour.
The surgery is performed under general anaesthesia and as a day care procedure. Patient can go home the same day after recovery from anaesthesia.
The most common complication is recurrence of the defect. Others complications include infection, difficulty in urination and stricture formation
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