Purpose
Thumb polydactyly and thumb hypoplasia are generally regarded as separate clinical entities.
However, several case reports indicate that hypoplasia of both the thumb and the radius
can occur in patients with thumb polydactyly and improved understanding of the genetics
of the developing upper limb may give an embryologic explanation for this occurrence.
Our hypothesis was that patients with preaxial polydactyly can have ipsilateral thumb
hypoplasia that may not be recognized until after surgical reconstruction of the extra
digit.
Methods
We searched our surgical database for all procedures performed on patients with a
diagnosis of preaxial polydactyly between 2002 and 2014. We reviewed the medical record
for demographic data, surgical procedures, and follow-up information. In addition,
all available radiographs were reviewed. Through this, we identified patients with
a diagnosis of ipsilateral thumb hypoplasia, including when in the course of treatment
the diagnosis was made, and any related subsequent procedures.
Results
We reviewed 132 patients who underwent reconstruction of thumb polydactyly, 10 of
whom were identified as having evidence of ipsilateral thumb hypoplasia, an incidence
of 8.2%. The diagnosis of thumb hypoplasia was made before surgery in 3 of the 10
patients. One additional patient was noted to have a duplicate thumb on one side and
a hypoplastic thumb on the contralateral side.
Conclusions
This study supports the hypothesis that children with preaxial polydactyly can have
ipsilateral thumb hypoplasia that may not be noted before surgery. In this study group,
8% of patients with preaxial polydactyly had ipsilateral hypoplasia.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: January 13, 2020
Accepted:
November 6,
2019
Received:
April 11,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
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