Nail size and appearance following nail fusion plasty of thumb duplication✰

We report greater than 10-year outcomes in duplicated thumbs following corrective cartilaginous resection during the growth period. We have undertaken corrective resection of cartilaginous joint connections based on intraoperative arthrographic findings to reconstruct favourable alignment in six Wassel Type II and IV thumb duplication in six patients. The age at surgery was 13 months (range 10–15), and the average post-surgical follow-up was 134 months (range 120–160). We observed five excellent and one good outcome using the Japanese Society for Surgery of the Hand scoring method. Favourable joint congruency and alignment were preserved, and no growth plate arrest or joint space narrowing was present more than 10 years after surgery. We conclude that corrective resection of the cartilaginous joint based on intraoperative arthrographic findings has long-term reliability for duplicated thumbs, especially those of Wassel Type II and IV, which have a cartilaginous joint connection. Levels of evidence: IV

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The OMT Classification of Congenital Anomalies of the Hand and Upper Limb

Hand Surgery ◽

10.1142/s0218810415400055 ◽

2015 ◽

Vol 20 (03) ◽

pp. 336-342 ◽

Cited By ~ 12

Author(s):

Michael A. Tonkin ◽

Kerby C. Oberg

Keyword(s):

Upper Limb ◽

Congenital Anomalies ◽

Limb Development ◽

Main Group ◽

International Federation ◽

Scientific Committee ◽

Current Status ◽

Thumb Duplication ◽

The Common

The Oberg, Manske and Tonkin (OMT) Classification of congenital anomalies of the hand and upper limb uses dysmorphological terminology, placing conditions in one of three groups: Malformations, Deformations and Dysplasias. The main group, Malformations, is further subdivided according to whether the whole of the limb is affected or the hand plate alone, and whether the primary insult involves one of the three axes of limb development and patterning or is non-axial. The common surgical diagnoses, such as thumb duplication and thumb hypoplasia, are then placed within this framework. Recently the International Federation of Societies for Surgery of the Hand Scientific Committee for Congenital Conditions approved the OMT Classification as a timely and appropriate replacement of the previously accepted Swanson Classification. This review charts the development of and modifications to the OMT Classification and its current status.

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Neurovascular Island Flap for Pulp and Nail Augmentation in Thumb Duplication Reconstruction: A Surgical Method With Long-Term Follow-Up

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2020.09.012 ◽

2021 ◽

Author(s):

Michael Chu-kay Mak ◽

Pak-cheong Ho ◽

Esther Ching-san Chow ◽

Bo Liu ◽

Wing-lim Tse

Keyword(s):

Island Flap ◽

Surgical Method ◽

Thumb Duplication ◽

Long Term Follow Up

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On-Top-Plasty for Atypical Thumb Duplication: A Case Report With 10 Year Follow-up

Hand ◽

10.1177/1558944718770770 ◽

2018 ◽

Vol 13 (4) ◽

pp. NP17-NP19 ◽

Cited By ~ 2

Author(s):

Albert Pons-Riverola ◽

Eric Camprubi-Garcia ◽

Sergi Barrera-Ochoa ◽

Josep M. Bergua-Domingo ◽

Jorge Knorr ◽

...

Keyword(s):

Case Report ◽

Ulnar Side ◽

Cosmetic Appearance ◽

Radial Side ◽

Right Hand ◽

Thumb Duplication ◽

Hypoplastic Thumb

Background: A very uncommon pattern of thumb duplication consists of an ulnar-side floating thumb and a radial-side distally hypoplastic thumb. Methods: We report the case of a 15-month-old child with this type of thumb duplication on his right hand treated with an on-top-plasty technique. The ulnar-side segment was pedicled and transferred to the lateral thumb, which was distally resected. Results: A well-aligned and widely mobile thumb with a wide first web and an excellent cosmetic appearance was exhibited 10 years after surgery. Conclusions: On-top-plasty technique might be amenable to reconstruct certain atypical thumb duplications.

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Floating thumb duplication: characteristics of the preserved anlage before and after surgical correction

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420948383 ◽

2020 ◽

pp. 175319342094838

Author(s):

Megumi Hanaka ◽

Kousuke Iba ◽

Toshihiko Yamashita

Keyword(s):

Surgical Correction ◽

Thumb Duplication ◽

Before And After

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Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication

Handchirurgie · Mikrochirurgie · Plastische Chirurgie ◽

10.1055/a-0893-6659 ◽

2019 ◽

Vol 52 (02) ◽

pp. 147-150

Author(s):

Kun Wang ◽

Fangxin Ai ◽

Pan Zhou ◽

Zhiwei Liu ◽

Zhenbing Chen ◽

...

Keyword(s):

Metacarpophalangeal Joint ◽

Suture Technique ◽

Wedge Osteotomy ◽

Angular Deformity ◽

Opening Wedge ◽

Type Iv ◽

Pull Out ◽

Thumb Duplication ◽

The Right ◽

Pull Out Suture

Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.

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