Radiographic Indicators of a Shared Epiphysis in Radial Polydactyly

Johnson, Michael H.; Melvani, Roshan T.; Patel, Neil N.; Cheng, Christine J.; Hutchison, Richard L.

doi:10.1007/s11552-013-9593-7

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…In 2014, Johnson et al approximated the most proximal bones involved in the duplication on PA radiographs of the thumb to distinguish between a separate and shared epiphysis. 16 But that measurement method was complicated and time consuming. In addition, it could not provide information on other cartilaginous structures apart from demonstration of the existence of a shared epiphysis.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging Provides Practical Information for Preoperative Assessment of Radial Polydactyly with Bifurcation at the Metacarpophalangeal Joint Level

Du¹,

Jiang²,

Wang³

et al. 2022

IJGM

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Purpose We aimed to evaluate the use of magnetic resonance imaging (MRI) to visualize unossified bone sites that are often not visible with radiography in pediatric radial polydactyly patients with bifurcation at the metacarpophalangeal (MP) joint level. The MRI validation could help in planning for surgical procedures. Patients and Methods A total of 141 thumbs in 139 pediatric patients with bifurcation at the MP joint on radiography were included in this study. All the patients had undergone MRI with proton density-weighted fat-suppressed fast spin-echo (FS PDWI) sequence and fast fat-suppressed 3D spoiled gradient-recalled echo (FS 3D SPGR) sequence. The MR images of the cartilaginous structure and joint characteristics at the MP joint were evaluated and categorized by two experienced radiologists. Results Our analysis demonstrated that MR imaging, especially the FS 3D SPGR sequence, yields better visibility of the cartilaginous structure and shows clearer joint characteristics that could not be detected by radiography. The abnormalities included a cartilaginous connection on the base of duplicated proximal phalanx, cartilaginous joint connection and the shape of articular cartilage on the head of metacarpal and soft tissue band. Radiologically encountered duplications at the MP joint level were successfully classified into six types based on the MRI-detected structural changes. The distribution of the six types was 17.7% (25/141) in type 1, 53.9% (76/141) in type 2, 2.8% (4/141) in type 3, 9.9% (14/141) in type 4, and 13.5% (19/141) in type 5. Conclusion This data showed that MR imaging provides practical information on the anatomic characteristics in radial polydactyly with bifurcation at the MP joint level that could aid surgical decision-making processes. Thus, the FS 3D SPGR sequence could be used as a MR imaging technique in radial polydactyly.

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Section: Discussionmentioning

confidence: 99%

MR Imaging Provides Practical Information for Preoperative Assessment of Radial Polydactyly with Bifurcation at the Metacarpophalangeal Joint Level

Du¹,

Jiang²,

Wang³

et al. 2022

IJGM

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show abstract

“…Some surgeons use plain radiographs to distinguish Wassel Type IV duplicated thumbs with a separate epiphysis from a shared epiphysis to aid in surgical planning (Johnson et al., 2014). However, in small children, the epiphyses are usually not ossified, and radiographs do not adequately reveal the epiphyses or the morphology of the cartilage.…”

Section: Discussionmentioning

confidence: 99%

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

Wang

Ding

Wang

et al. 2021

J Hand Surg Eur Vol

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We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

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Preoperative percutaneous arthrography provides detailed information for treatment of Wassel type IV thumb duplication

Liu

Zhong

et al. 2018

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Radiographic Indicators of a Shared Epiphysis in Radial Polydactyly

Cited by 3 publications

References 10 publications

MR Imaging Provides Practical Information for Preoperative Assessment of Radial Polydactyly with Bifurcation at the Metacarpophalangeal Joint Level

MR Imaging Provides Practical Information for Preoperative Assessment of Radial Polydactyly with Bifurcation at the Metacarpophalangeal Joint Level

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

Preoperative percutaneous arthrography provides detailed information for treatment of Wassel type IV thumb duplication

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