Growth of the Reconstructed Thumb after Surgical Correction of Unilateral Polydactyly: Radiologic Evaluation

Journal of the Korean Society for Surgery of the Hand 2008;13(3):205-211.
Published online September 1, 2008.

Joon Kyu Park, Jeong Mok Cho, Seung Hyun Ahn, Sung Tack Kwon

편측 수무지 다지증에서 방사선 계측으로 본 재건된 무지의 성장

박준규, 조정목, 안승현, 권성택

Abstract

Background: Polydactyly of the thumb is the most common congenital anomaly of the hand with diverse morphology. It has been supposed that pre-axial polydactyly accompanies the hypoplasia of the thumb. However, there is no confirmative study of systematic measurements and statistical analysis before and after the surgery. Aims: The purpose of this study is to evaluate the growth of the reconstructed thumbs after surgical correction of pre-axial polydactyly. Methods: Unilateral thumb polydactyly of 80 cases (excluded floating type), which were operated from January 1998 to July 2005, were evaluated. Average age at the time of operation was 12.1 months (6~36 months). Width and height of phalangeal bones were measured on simple radiograph at the time of operation, 6 months, 1 year and 2 years after the operation. Both relative ratio to normal thumbs and absolute values were analyzed statistically related to both morphological types and the surgical procedures. Results: At 2 years after surgery, there were no significant differences in the growth and the ratio of length between normal and reconstructed thumbs. Shortened phalanges by wedge osteotomy, noticed at 6 months postoperatively (p<0.01), recovered its length after 12 months. Proximal head resection reduced size of it and its ratio were maintained during growth until 2 years (p<0.01). Discussion: Though further studies including both functional and soft tissue relationship are necessary to support our results, the bony size of reconstructed thumb was not smaller than that of normal side at 2 years after surgery. Conclusions: Our study might suggest that the reconstructed thumb would grow as unaffected one does as far as proper correction was done. An aggressive intervention for improving the aesthetics and function can be rationalized without risks to do harm to the growth.