Evaluation and Management of Preaxial Polydactyly

Abstract

Purpose of Review To provide a current review of the embryology, classification, evaluation, surgical management, and clinical outcomes related to preaxial polydactyly. Recent Findings Recent studies include a proposed embryologic link between preaxial polydactyly and other congenital abnormalities, an evaluation of long-term postsurgical outcomes, and an examination of important predictors for postsurgical outcomes. Summary Preaxial polydactyly, while relatively uncommon, is a complex congenital hand abnormality that requires careful preoperative classification and proper surgical intervention timing to yield optimal outcomes.

Preaxial polydactyly of the foot in an adult patient diagnosed by X-ray after a trauma

“…Indeed, the duplication of the big toe is rarer than the polydactyly of the thumb, with reported incidence rates of 0.024/1000 and 0.165/1000 respectively [ 6 , 8 ]. The duplication of the big toe has been reported more frequently in males, mainly affecting the right foot, and being more frequently one-sided (81.5%) [ 9 , 10 ]. Even if the exact pathophysiology of isolated polydactyly remains unknown, a possible correlation with maternal diabetes has been suggested, but data from literature are still poor [11] .…”

Thumb Duplication Surgical Treatment: Outcomes and Results

“…This malformation, due to abnormal radioulnar axis formation/differentiation of the hand plate, can affects the ulnar side of the hand (postaxial), the most common type, the radial side of the hand (preaxial), also known as radial polydactyly, thumb duplication or split thumb, the second most common type ( Figure 1 ), or the center of the hand (central). 1 , 2 …”

“…3 Classification of the deformity is an important aspect of the evaluation process, as the type of the thumb duplication determines prognosis, surgical approach, operative complications, and post-surgical outcomes. 1 , 4 , 5 …”

“… 7 Polydactyly is usually unilateral, not associated with familiar inheritance patterns, but may be associated with systemic conditions such as Holt-Oram or Fanconi’s anemia, specifically Wassel-Flatt type VII. 1 , 7 …”

“…In cases where one of the thumbs is better developed proximally while the other is better developed distally, an on-the-top plasty, preserving the neurovascular function of the distal segment, may be used. 1 …”