American Association for Hand Surgery

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Treatment of Wassel IV Polydactyly of Thumb
PT Chan, MD, Tuen Mun Hospital, Hong Kong, Hong Kong


Polydactyly of the thumb is one of the commonest congenital differences of the upper extremity in Asian country. The incidence is estimated to be 1-2 per live birth in China. The presentation varies from simple skin tag to complex polysyndactyly. Treatment will vary according to the types of duplication. We managed Wassel IV polydactyly by bony re-alignment, soft tissue balancing and meticulous design of skin flaps.

Material & Methods:

We reviewed our patients with Wassel IV thumb duplication managed in our hospital since 2006. We employed oblique intra-articular osteotomy of the metacarpal of joint re-alignment procedure is needed. Tendon re-alignment and collateral ligament reconstruction was also performed.


15 patients were reviewed. They all showed a stable and well-aligned thumb for opposition. There was no peri-operative complication and no case of growth disturbance. There was no revision surgery needed in all cases. Although the alignment is satisfactory, the interphalangeal joint motion is usually stiffer than the normal side.


Intra-articular osteotomy is a safe method for re-align the joint orientation in Wassel IV polydactyly.

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