Duplication of the Thumb

Naasan, Anas; Page, Robert E.

doi:10.1016/0266-7681(94)90089-2

Cited by 66 publications

(13 citation statements)

References 7 publications

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“…4). The same principles and techniques apply to these problems when encountered in any of the other Wassel types, but it is illustrative to detail the techniques used when all elements listed above are deficient in a type IV deformity 3-12)…”

Section: Surgical Techniquesmentioning

confidence: 99%

Thumb Duplication: Concepts and Techniques

Tonkin

2012

Clin Orthop Surg

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Within the Oberg, Manske, Tonkin (OMT) classification, thumb duplications are a failure of formation and/or differentiation affecting the radial-ulnar axis of the hand plate. The Wassel description of seven types of thumb duplication provides a good structure from which an approach to management is based. The aim of surgical reconstruction is to obtain a stable, mobile thumb of adequate size and appropriate shape. The most common form of reconstruction is removal of the lesser digit and reconstruction of the dominant digit. Surgical techniques address the problems of deviation, instability and lack of size. The disadvantages of the Bilhaut-Cloquet procedure, these being joint stiffness and a nail ridge, may be lesser concerns when reconstruction of one digit will not create a satisfactory thumb of adequate mobility, stability, alignment and size. Complicated problems of triphalangism, triplication, ulnar dimelia and the rare circumstance in which neither of the duplicated thumbs may be adequately reconstructed present specific challenges which demand alternative techniques.

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Section: Surgical Techniquesmentioning

confidence: 99%

Thumb Duplication: Concepts and Techniques

Tonkin

2012

Clin Orthop Surg

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“…However, there are differences in the specific proportions of each type reported. The results of this study in southwestern China show that type IV accounts for 39.7% of the affected population, while the proportion reported in another domestic study by Su et al, the Middle East study by Al-Qattan et al, the Japan study by Islam et al, and the UK study by Naasan et al show that type IV accounts for 29.6%, 35%, 33.6%, and 20.9% of the respective populations [ 10 – 12 ].This is different from our statistical results and may be associated with the sample size. This group of data has a large sample size, similar to the previous reports at home and abroad.…”

Section: Discussionmentioning

confidence: 63%

Epidemiological statistics of congenital thumb duplication in the Chinese population

Yao

Zhou

et al. 2021

J Orthop Surg Res

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Background Thumb duplication is a very common congenital malformation. This study describes and compares the phenotypic manifestations of polydactyly between southwest and northeast China. However, previous studies had a limited sample size. Therefore, this study used a large sample. Methods A total of 3549 well-characterized thumb duplication cases were divided into group A (southwest China) and group B (northeast China). Results In group A and group B, the left-to-right ratio was 1:1.5 and 1:1.75, respectively, and the female-to-male ratio was 1:1.5 and 1:1.58, respectively. Conclusions There were no significant differences in gender distribution or the distribution of left and right polydactyly between the two groups, but the distribution of bilateral polydactyly was significantly different.

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“…There are 4 surgical methods to approach reconstruction of preaxial polydactyly: (1) simple excision of the duplicated digit, (2) excision of the duplicated digit with reconstruction of the soft tissues, (3) wedge resection of central bone and soft tissue (Bilhaut-Cloquet procedure), and (4) on-top plasty. Simple excision was initially advocated, but subsequent follow-up studies showed unacceptable thumb function and appearance, as it fails to align joint surfaces and epiphyses perpendicular to the long axis of the thumb, centralize the flexor and extensor tendons, and provide adequate collateral ligaments for joint stability 42,46,47 .…”

Section: Preaxial Polydactylymentioning

confidence: 99%

Congenital Disorders of the Pediatric Thumb

Nguyen

2022

JBJS Reviews

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» Surgical timing for pediatric trigger thumb treatment is controversial for numerous reasons including the potential for spontaneous resolution, the possibility of bilateral involvement, and anesthesia concerns regarding the developing brain. Hence, a reasonable approach is to delay the surgical procedure until the patient is ≥3 years of age.» Preaxial polydactyly is usually unilateral and sporadic, with the most common reconstruction method consisting of excision of the diminutive thumb with preservation and soft-tissue reconstruction of the dominant thumb. The surgical procedure is typically performed around the patient age of 1 year to decrease the risks of anesthesia but allow reconstruction prior to the development of a tip-to-tip pinch.» Triphalangeal thumb and thumb hypoplasia are often found in the setting of systemic anomalies such as Holt-Oram syndrome, thrombocytopenia absent radius syndrome, Fanconi anemia, VACTERL (vertebral anomalies, anal atresia, cardiac anomalies, tracheoesophageal fistula, renal defects, and limb anomalies), and/or Blackfan-Diamond anemia. As such, patients should receive adequate workup for these entities. A surgical procedure should be performed only once patients have been medically cleared.» The status of the carpometacarpal joint in thumb hypoplasia determines whether reconstruction with first web space deepening, collateral ligament stabilization, and opponensplasty compared with index pollicization is performed.

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Duplication of the Thumb

Cited by 66 publications

References 7 publications

Thumb Duplication: Concepts and Techniques

Thumb Duplication: Concepts and Techniques

Epidemiological statistics of congenital thumb duplication in the Chinese population

Congenital Disorders of the Pediatric Thumb

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