This patient has an uncommon type of extra thumb. There are really two issues. First, there are really two extra thumbs. And second, there are five fingers (including the most radial one being in the plane of the fingers).
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Unusual radial polydactyly (extra thumb) |
X-ray showing the extra thumb (or 2 thumbs) with 5 fingers. |
Initially, we made a decision with the family to remove the extra thumbs. Structurally, there is no 'great' thumb and creating a useful thumb would be difficulty if not impossible. Instead, we focused on removing these thumbs and then better understanding if a second surgery would be necessary. There was a possibility that the patient would be sufficiently function with a five finger hand.
Here is the hand after the first surgery.
View after surgery. Now a 5- finger hand |
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5- finger hand after surgery |
Ultimately, we decided that additional surgery made sense for function primarily but also appearance. This is a triphalangeal thumb that is largely in the plane of the fingers making pinch a challenge. There are different approaches but we elected to perform the pollicization procedure and are pleased with the early results.
After pollicization surgery, 4 week visit |
Another view after pollicization surgery |
Thanks for reading,
Charles A. Goldfarb, MD
email: congenitalhand@wustl.edu
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