Duplication of the Thumb. A Retrospective Review of Two Hundred and Thirty-Seven Cases

Tada, Koichi

doi:10.1097/01241398-198311000-00026

Cited by 31 publications

(90 citation statements)

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“…Since the grip thumb-second finger appears when the child is about 1-year of age [2,6], surgery is usually carried out at this age to facilitate the child's motor development as well as to reduce for anaesthesia-related risks. In terms of the Tada scoring system, our results are consistent with those reported by Tada in his own study [4]. Axial deviations are the most frequent side-effects of surgery [7,9].…”

Section: Discussionsupporting

confidence: 82%

“…If the thumbs are not symmetrical, most surgeons propose this sequence: resection of the most hypoplastic thumb (more often the radial one), followed by reinsertion of the articular capsule and the collateral ligament. Some surgeons also recommend an arthroplasty of the head of the first phalange with centralisation of the extensor and flexor tendons [1,4,6,18]. If clinodactyly is noted, an osteotomy of the first phalange is performed [4,6,14,18].…”

Section: Discussionmentioning

confidence: 99%

“…Satisfaction of children's parents was assessed using a simple scale: very satisfiedsatisfied -not very satisfied -not at all satisfied. The results were evaluated according to the Tada scoring system [4], which is based on the range of active motion of the IP and MCP joint, the alignment and the stability (Table 1). Based on such criteria, the results were classified as good (4-5 points), fair (2-3 points) and poor (1 point or less).…”

Section: Methodsmentioning

confidence: 99%

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Results after surgical treatment of thumb duplication: A retrospective review of 33 thumbs

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Fron

Martinot-Duquennoy

et al. 2007

Journal of Children's Orthopaedics

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Results The mean postoperative follow-up was 3 years and 11 months. According to Wassel's classification, the series included 12 type II duplications, two type III, 14 type IV, two type V, one type VI and two type VII. The surgical approaches consisted of simple resection of the most hypoplastic thumb (16 thumbs), the Bilhaut-Cloquet procedure (ten thumbs) and resection associated with reconstructive surgery (seven thumbs). The Bilhaut-Cloquet procedure was used in three cases for treatment of type IV duplication On the basis of the Tada scoring system, we obtained 24 good results, eight fair results and one poor result. Conclusion Based on our results, we recommend the use of Bilhaut-Cloquet procedure not only for the treatment of type II duplication when the thumbs are both hypoplastic and symmetric, but also for type IV duplication with the same clinical parameters. For the other types of duplications, we consider that resection of the most hypoplastic thumb associated with reconstructive surgery is the best surgical approach. For type VII duplication, ablation of the triphalangeal thumb remains the best option. We do not recommend osteotomy at the first surgery.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Results after surgical treatment of thumb duplication: A retrospective review of 33 thumbs

Maillet

Fron

Martinot-Duquennoy

et al. 2007

Journal of Children's Orthopaedics

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“…The difference in age between our mean age (20 months) and that in other studies may be due to our long waiting list, which delays surgery. Exceptionally, only one author group, Tada et al, recommends operating at 6 months [16]. Yen et al [1] postpone surgery and operate at a mean age of Results were 91 % good (4 and 5), 8 % fair (3 and 2), and none poor.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of age and Wassel classification in the reconstruction of thumb duplication

González

Mora

Soto

et al. 2013

Journal of Children's Orthopaedics

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Background Various surgical techniques for thumb duplication have been described. The main goal in thumb reconstruction is to achieve optimal function, stability, and shape. Few publications have quantified the functional results of each surgical option and factors that may affect these outcomes. Methods We performed a retrospective review during the period from 1990 to 2011 of 115 surgery patients, 99 of whom had a mean postoperative follow-up of 44.1 months. They were classified according to the Wassel classification. We assessed the surgical technique, functional results, and complications, and evaluated the probable prognostic value of age and Wassel classification. Results This case series comprised mainly female patients (62 %) and the right hand (74 %), with a mean age at operation of 20 months. The most common group was Wassel type IV (54 %). On the basis of the Tada scoring system, we obtained 91 good results (91 %). Complications occurred in 27 patients (27 %), mainly instability and axis deformation. In a comparison of preoperative factors (age at the time of surgery and Wassel classification) with the final results (Tada score and complications), the association between older age at surgery and complications (p = 0.0001) and Wassel types III and IV and complications (p = 0.0210 and p = 0.0095) was statistically significant. Conclusions Following the basic concepts of anatomical reconstruction, we obtained good results in most patients. The main complications were instability and axial deformity. These were most common in patients who underwent operations at an age of more than 12 months, and patients with Wassel types III and IV deformities.

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“…The distribution ratio of different types of thumb polydactyly closely resembled previous reports. [13][14][15] The mean age of the patients at the time of operation was 2.8 (range, 0.6-47) years and the mean follow-up period was 5.3 (range, 2-10) years (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Thumb Polydactyly: Clinical Outcome after Reconstruction

Yen

Chan

Leung

et al. 2006

J Orthop Surg (Hong Kong)

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Purpose. To evaluate clinical and cosmetic outcomes of reconstruction in thumb polydactyly and prognostic value of the Wassel classification. Methods. Between 1993 and 2000 inclusive, out of the patients with thumb polydactyly (involving 80 thumbs) operated on, 34 patients (36 thumbs) were available for review and underwent clinical and radiological assessment. Outcomes in terms of the Tada score and complications were recorded. Results. The mean age of patients at the time of operation was 2.8 (range, 0.6-47) years. The mean follow-up period was 5 (range, 2.4-10) years. According to the Wassel classification, 12 were type-II thumb polydactyly, 3 type-III, 11 type-IV, 6 type-V, one type-VI, and 3 type-VII. There was no perioperative mortality or wound infection. More than 88% of the patients were satisfied or very satisfied with functional and cosmetic outcomes. Postoperative complications such as scar hypertrophy, pulp atrophy, joint deformity, and instability were common but minor. Ridge nail deformity after the Bilhaut Cloquet procedure was amenable to second- [295][296][297][298][299][300][301][302] ary corrective procedures. All types of operated thumb polydactyly achieved similar mean Tada scores (14.7-16.6 out of 20). The Wassel classification category, age, and surgical procedures were found to have no prognostic value with regard to the Tada score and presence of complications. Conclusion. Surgery on thumb polydactyly is rewarding. The Wassel classification category can be used as a guide for treatment, although it fails to predict the occurrence of postoperative complications or Tada scores. Our patients' results can serve as guidelines of expected outcomes after reconstructive procedures in different sub-types of thumb polydactyly.

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Duplication of the Thumb. A Retrospective Review of Two Hundred and Thirty-Seven Cases

Cited by 31 publications

References 0 publications

Results after surgical treatment of thumb duplication: A retrospective review of 33 thumbs

Results after surgical treatment of thumb duplication: A retrospective review of 33 thumbs

Prognostic value of age and Wassel classification in the reconstruction of thumb duplication

Thumb Polydactyly: Clinical Outcome after Reconstruction

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