Congenital Differences-Case: Radial Polydactyly Reconstruction

Case: Radial Polydactyly Reconstruction

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Radial polydactyly is a condition where a person has an extra thumb on the radial side of their hand. In the case of a 2-year-old with radial polydactyly, the most common type is Wassel IV. To reconstruct the hand, the surgical plan involves creating one thumb using the best parts from each duplicated thumb. The dominant thumb is preserved, and parts from the ablated thumb are used to construct the new thumb. The alignment of the thumb is corrected, taking into consideration the bones, ligaments, and tendons.<br /><br />One principle in the reconstruction is the use of collateral ligaments. An osteoperiosteal sleeve is mandatory for duplications that arise from the joint surface. Another principle is bony alignment, where if there is malalignment, an osteotomy may be necessary to correct it. The musculotendinous structures, including the location, insertion, and connections of the muscles and tendons, are also considered in the reconstruction.<br /><br />The surgical plan for the metacarpophalangeal (MP) joint involves maintaining the ulnar component, releasing and preserving the radial collateral ligament (RCL), excising the radial component, and attaching the RCL to the ulnar component. This plan helps to reconstruct the thumb and ensure proper alignment.<br /><br />Overall, the surgical reconstruction for radial polydactyly in this case involves selecting the best parts from both thumbs, correcting any misalignment, and considering the muscles, tendons, ligaments, and bones in the hand to create a functional and aesthetically pleasing thumb.

Keywords

radial polydactyly

extra thumb

Wassel IV

surgical plan

thumb reconstruction

alignment

bones

ligaments

tendons

muscles