the site you are agreeing to our use of cookies. and by advanced students in science and medicine. information that you need at your fingertips. Triphalangeal thumb is a form of pre-axial polydactyly with an incidence of 1 in 25,000. To ensure long-term funding for the OMIM project, we have diversified When radial polydactyly is present it may be classified according to Wassel (1969) or the updated version by Zuidam et al. In these cases, especially in the long thumbs, this was always combined with a shortening osteotomy, with rotation and abduction at the metacarpal level. Opposition plasties were always performed in a later stage and ultimately these were only performed in 20% of operated thumbs. A 2-year-old otherwise healthy girl presented with fixed ulnar deviation of the interphalangeal joint of the left thumb. In our series in the earlier years, the thumbs of the five-fingered hands were pollicized as described above. Flow chart for the surgical treatment of triphalangeal thumb. Triphalangeal thumbs have an incidence of 1 in 25,000 7.. ,{i:'fig3-1753193418797922',type:'fig',g:[{m:'10.1177_1753193418797922-fig3.gif',l:'10.1177_1753193418797922-fig3.jpeg',size:'1 MB'}]} Wood BP, Reading GP (1977) Case Report 30: Longitudinally Bracketed Diaphysis (\"Delta Phalanx\" Anomaly). Treatment of the triphalangeal thumb. In these patients, the long TPT is pollicized in the same manner as the index finger for a hypoplastic or absent thumb. The ratio of the length of the second metacarpal divided by the length of the first metacarpal was compared with the same ratio in a normal population (Garn et al., 1972; Gefferth, 1972). The reduction at the DIP joint is about 1 cm. Triphalangeal thumb is noted as well. In 17, a DEL procedure was performed and in 16, a DIPRAD procedure. Thank you in advance for your generous support, A transposition flap from the dorsum is an alternative. Skeletal Radiol 34:468-76 (PMID: 15947976), [5] The thumb appearance can be thumb-like to more finger-like. Wood also advocated transposition of the rudimentary bi-phalangeal thumb to the base of the TPT metacarpal, where it could grow further. Upton and Shoen, on the contrary, preserve and correct the TPT part and excise the rudimentary bi-phalangeal thumb (Upton, 1999). In contrast to the hypoplastic thumb, ulnar collateral ligament reconstruction was usually not necessary (de Kraker et al., 2016). (a) and (b) Postoperative results after DIP joint arthrodesis with metacarpal shortening. Pollicization of the 1st digit was performed ten times before 2000. The first web can be normal to aberrant and the thenar muscles hypoplastic, malformed or absent. In most cases the CMC joint is less mobile and less well-developed, particularly when the thumb is finger-like, when it is similar to the second CMC joint. The e-mail addresses that you supply to use this service will not be used for any other purpose without your consent. Triphalangeal thumb (TPT) is a congenital hand anomaly in which the thumb has an additional phalanx, supposedly first described by Columbo in 1559 (Columbo-Cremonensis, 1559). Their thumbs are mostly non-opposable. For more information view the SAGE Journals Sharing page. Tonkin, MA, Beard, AJ, Kemp, SJ, Eakins, DF. The normal first metacarpal has a growth plate at the proximal end of the metacarpal. (c)–(e) Peri- and postoperative images following this procedure. In even larger first web defects, Upton used a distally based radial forearm fasciocutaneous flap for coverage (Upton, 1999). The thumb can be long with a finger-like appearance. Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. Zguricas, J, Snijders, PJLM, Hovius, SER, Heutink, P, Oostra, BA, Lindhout, D. Zuidam, JM, de Kraker, M, Selles, RW, Hovius, SER. Brought to you by the European Society of Radiology (ESR) -. Hand Surgery. amelliott@mts.net In patients with bifid distal phalanges, nails could be very broad. Therefore, parents mostly seek correction of the deformity for their children because of the appearance of the TPT. Triphalangeal thumb with … There is an autosomal … Ogden JA, Light TR, Conlogue GJ (1981) Correlative Roentgenography and Morphology of the Longitudinal Epiphyseal Bracket. In these cases, the CMC joints and metacarpals of the radial rays were apparently well developed. If opposition strength has to be improved due to thenar muscle deficiency, an opposition plasty can be performed. (b) The skin is incised in a Y over the DIP joint; following incision of the extensor tendon and collateral ligaments the middle phalanx is reduced substantially and the distal phalanx at its edge to prevent damaging nail growth. ]}. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Garn, SM, Hertzog, KP, Poznanski, AK, Nagy, JM. Various joints, ligaments, muscles, and tendons of the first ray can be hypoplastic or absent, with varying degrees of stiffness or instability. window.figureViewer={doi:'10.1177/1753193418797922',path:'/na101/home/literatum/publisher/sage/journals/content/jhsc/2019/jhsc_44_1/1753193418797922/20190108',figures:[{i:'table1-1753193418797922',type:'table-wrap',g:[{m:'10.1177_1753193418797922-table1.gif',l:'10.1177_1753193418797922-table1.jpeg',size:'103 KB'}]} Mostly there is a degree of radial or ulnar clinodactyly due to the wedge or trapezoidal shape. The functional problem that arises in many patients is deficient opposition resulting in difficulty with activities like writing, picking up smaller objects, etc. The degree of opposability of the thumb relates to the thenar muscle deficiency. Measurements of length], The gene for triphalangeal thumb maps to the subtelomeric region of chromosome 7q, Combined reduction osteotomy for triphalangeal thumb, [Treatment and study of the hypoplastic thumb], Sesamoid arthrodesis for hyperextension of the thumb metacarpophalangeal joint, The results of surgery for polydactyly of the thumb. In nearly all patients with radial polydactyly, the radial ray was less developed than the ulnar ray. Patients functioned well although five thumbs had instability at the MP joint level. New login is not successful because the max limit of logins for this user account has been reached.