Complications after radial polydactyly surgery: analysis, prevention and management

Abstract

Long-term follow-up after surgical correction of patients with radial polydactyly might reveal unexpected or undesired outcomes that are accentuated by growth. It should be stressed that assessment of outcomes differs considerably by the system used. Preoperative examination can elucidate the underlying pathological anatomy of these anomalies and consequently, these anatomical differences should be corrected as much as possible during the first operation to prevent worse outcomes at long-term follow-up. In various long-term studies, the reoperation rate was in the range of 7%–28%, with the most common reasons being deviation, instability, nail deformity and suboptimal appearance. Most unfavourable results occur during growth and are frequently revealed only at longer-term follow-up. Concentration of care to a few centres is advised since these malformations occur in small numbers and experienced surgeons tend to have better results. Consensus on the used assessment system and multicentred studies are essential in future to better understand how we can prevent reoperations.

Experience with Management of Radial Polydactyly: The Multicenter Analysis of 28 Surgical Procedures with Follow-Up

“…From our results, it can be concluded that there is no uniform consensus on which Wassel types have relatively good outcomes and which types tend to have worse expected clinical outcomes. Hovius and Kruit, in their comprehensive review, have highlighted that the most unfavorable outcomes often manifest during the growth period and may only become apparent in more extended follow-up assessments [32]. Therefore, it is important to acknowledge that, during our follow-up assessments, certain limitations in clinical outcomes may not have fully presented themselves.…”