Purpose
The aim of the study was to present the intraoperative findings of the relevant digital
nerves of the duplicated thumbs in an excision and reconstruction procedure for the
Wassel–Flatt type Ⅳ radial polydactyly.
Methods
The study was conducted on patients with Wassel–Flatt type IV radial polydactyly who
underwent excision and reconstruction between 2018 and 2021 at our institution. The
ulnar digital nerve of the radial thumb and the radial digital nerve of the ulnar
thumb were identified and traced intraoperatively. The level of the bifurcation of
the nerves and abnormal findings were documented.
Results
A total of 123 hands in 119 patients were included in this study. In 114 hands, the
bifurcation of the nerves was located within 1 cm of the metacarpophalangeal flexion
crease. The radial digital nerve to the ulnar thumb was abnormally compressed in deep
fascial tissue in 7 of these 114 hands. In 5 hands, the level of bifurcation was more
than 1 cm proximal to the crease. No radial digital nerve to the ulnar thumb was identified
in the remaining 4 hands.
Conclusions
Although rare, abnormal nerve compression of the digital nerve may exist in duplicated
thumbs of Wassel–Flatt type IV radial polydactyly.
Clinical relevance
In an excision and reconstruction procedure, we suggest that the bifurcation of the
nerves should be identified before the nerve to the radial thumb is excised to avoid
injuring the nerve to the main ulnar thumb.
Key words
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Article info
Publication history
Published online: September 10, 2022
Accepted:
July 20,
2022
Received:
October 29,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Financial disclosure: Work in this publication was supported under Award Number SKY2021052.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
