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

Hanaka, Megumi; Iba, Kousuke; Yamashita, Toshihiko

doi:10.1177/1753193420948383

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Beyond the evident aesthetic concerns, these anomalies significantly impact hand function and overall limb dexterity. Conventional reconstructive methods have centered around metacarpal augmentation, tendon transfers, and soft tissue reconstruction [13,14]. In a previous study, Liu et al focused specifically on surgical reconstruction for the more severe type IIIB and IV cases using a non-vascularized fourth metatarsal bone graft, which achieved reasonable hand function and cosmesis in 16 patients with 17 type IIIB and IV hypoplastic thumbs over 46 months, despite 2 nonunions [15].…”

Section: Introductionmentioning

confidence: 99%

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Shi,

Duan,

2024

Med Sci Monit

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Background:Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin bridge. Surgical management options for this condition vary from amputation to flap reconstruction. Material/Methods:This retrospective study analyzed 11 infants with congenital hypoplasia of the thumb type IV who underwent surgical reconstruction using a modified vascularized polydactylous hallux flap. The study included 6 male and 5 female infants, aged 6 to 24 months. Functional evaluations and radiographic studies were conducted postoperatively. Results:All 11 patients underwent the complete surgical protocol. Successful vascular and nerve anastomoses were performed during the initial procedure, ensuring sufficient blood supply and neural connectivity to the transferred toes. The second operation showed promising outcomes, including improvements in thumb opposition, grasp strength, and overall function. Postoperative assessments demonstrated satisfactory radiographic alignment and no major complications during the follow-up period. Conclusions:The modified vascularized polydactylous hallux flap reconstruction is a viable surgical option for managing congenital hypoplasia of the thumb type IV in infants. This technique effectively restores thumb opposition, grasp strength, and overall hand function, with satisfactory radiographic alignment and minimal complications.The study findings support the efficacy and safety of this surgical approach in addressing this rare congenital anomaly.

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Section: Introductionmentioning

confidence: 99%

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Shi,

Duan,

2024

Med Sci Monit

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“…Skeletal morphological abnormalities are prognostic factors for postoperative deformation, such as severely deviated joints in Wassel Type IV thumb polydactyly (Hong et al., 2021; Kim et al., 2017; Lee et al., 2013; Luangjarmekorn et al., 2021) and asymmetric morphology of phalanges (Saito and Morimoto, 2021). The presence of hypoplastic elements is also important; even a well-developed ulnar thumb with a very hypoplastic ‘floating’ radial thumb has the potential to cause joint deviation (Hanaka et al., 2021; Lourie et al., 1995; Saito et al., 2018).…”

Section: Introductionmentioning

confidence: 99%

Use of the duplication range concept for understanding morphology and predicting prognosis in thumb polydactyly

Saito

Makino

Yamanaka

et al. 2022

J Hand Surg Eur Vol

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This study systematically and comprehensively analysed 129 thumb polydactylies in 122 patients using a duplicating range concept based on the level of skin and skeletal bifurcation. Numerical levels were defined along the longitudinal axis of the ulnar thumb duplicate from distal to proximal: level 0 (thumb tip) to level 6 (carpometacarpal joint). The relationships between duplication range and morphological parameters were evaluated. Nail asymmetry was associated with skin bifurcation levels 0 to 2. Proximal phalangeal asymmetry and interphalangeal joint deviation, associated with skin bifurcation levels were assigned scores of 1 to 2.5 and 1 to 2, respectively. Metacarpophalangeal joint deviation had a bimodal distribution, at levels 1.5 and 4 of the longitudinal axes. Morphological similarity was found in patients with the same duplication range. The duplication range concept could potentially improve our understanding of morphology variation and predicting prognoses in thumb polydactyly. Level of evidence: III

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“…More recent reports have suggested that interphalangeal (IP) joint deviations can occur in conjunction with these types of radial polydactyly, a deformity that can persist or worsen after excision surgery (Lourie et al, 1995;Saito et al, 2018). Most recently, Hanaka et al (2021) investigated the clinical features of 12 patients with floating type radial polydactyly and found that two of the 12 thumbs showed a deviation at the IP joint preoperatively, which did not improve postoperatively. In addition, two of 10 patients with no deformity preoperatively developed IP joint deviation postoperatively.…”

mentioning

confidence: 99%

Interphalangeal joint deviation in floating-type radial polydactyly with malalignment of the flexor pollicis longus tendon: a case report

Saito

Morimoto

2021

J Hand Surg Eur Vol

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

Cited by 3 publications

References 3 publications

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Use of the duplication range concept for understanding morphology and predicting prognosis in thumb polydactyly

Interphalangeal joint deviation in floating-type radial polydactyly with malalignment of the flexor pollicis longus tendon: a case report

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