The varied forms of duplicated thumb in infants
Abstract
Hand polydactyly is a common congenital anomaly. It appears as a single disorder, or as a separate manifestation of a syndrome. In the Caucasian race, thumb duplication (preaxial polydactyly) is the most common form of hand polydactyly. The purpose of this study was to isolate cases of thumb duplication that were surgically treated during the time period 2008-2018, and to identify diagnostic pitfalls and therapeutic concerns. We studied twelve duplicated thumb cases and classified them according to their severity with Wassel’s classification system. All cases were treated by the same surgical team under general anesthesia using pneumatic tourniquet. In a 2-8-year follow-up period, patients were evaluated according to subjective and objective criteria, emphasizing on functional and aesthetic outcomes. On an evaluation scale, results were satisfactory for ten patients (83.34%), while two patients presented moderate results. We analyze the reasons for the moderate results and look for ways of avoiding them. In conclusion, preoperative planning is considered necessary, given the diversity of cases. Choosing the right timing protects both the physician and the patient from practical difficulties. Clinical examination is the patient’s first diagnostic approach, while simultaneously studying radiographs helps to identify the problem more accurately. The technique must follow the principles of plastic surgery.
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