Clinical Example: Correction bilateral triphalangeal thumbs

This infant has recovered from neonatal repairs of life threatening cardiac defects, and is declared fit enough to "fix her hands".

This particular situation falls somewhere between the five fingered hand (absent true thenar development, adducted, not pronated) and a pure triphalangeal thumb. The middle phalanx is a delta phalanx, and could have been treated with excision, although there is disagreement in the
literature about how well that procedure works.
Click on each image for a larger picture


Left hand:
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Immediately preop.
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Immediately preop.
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Immediately postop.
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Immediately preop.
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Immediately postop.
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Right hand.
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Immediately preop.
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Immediately preop.
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Immediately postop.
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The same type of procedure was performed on both hands at the same setting. This included a shortening/straightening proximal interphalangeal joint fusion and a shortening/pronating/abducting metacarpal osteotomy, along with extensor tendon shortening. Bone fixation at each site was with an intramedullary absorbable pin and intraosseous PDS sutures. Red areas are the areas of skeletal removal.
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Six months postop.
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Triphalangeal thumb
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