thumb duplication (radial polydactyly )
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%).
The goal is to create the best thumb possible using parts of each duplicate.
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).
Surgery is usually performed at 1 year, prior to development of thumb-index pinch.
Few minutes to hours, it depends on thumb deformity.
It depends on deformaty of thumb it can be performed in a day care setup.
Very few complications, depends on its type, infection, incomplete excision.
This complication can be easily avoided by performing surgery under loupes magnification, aseptic
technique, and postoperative care and by performing operation by properly trained plastic surgeon.
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