An extra thumb has been labeled many different ways: ‘radial
polydactyly, thumb polydactyly, split thumb, and duplicated thumb’. My preferred name is radial polydactyly
as it tells you exactly the issue.
The term ‘duplicated thumb’ is not ideal as the thumbs are both smaller
than normal but ‘split thumb’ is not perfect either because the thumbs are usually
more than 50% of the size of the opposite thumb.
Radial polydactyly is typically both a functional problem
and an appearance issue. Surgery
is recommended. However, surgery
is not simply removing the extra thumb- it is a reconstructive procedure that
can range from a moderately complex procedure to a very complex procedure. There is no ideal time for surgery but
typically surgeons choose to operate between 1 and 2 years of age. Sometimes the thumbs are merged to make
the best, combined thumb and sometimes the bigger, more mobile thumb is
reconstructed to make it stable and straight. Surgery can involve soft tissues only but often also
involves bone surgery. A second
procedure is required in some patients as they get older.
In this case, an older child had the smaller, outer thumb
removed with a stabilization and reconstruction of the larger thumb.
Before Surgery
After Surgery
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