Surgical Treatment of Axial Polysyndactyly and Postaxial Polydactyly of The Hand in Korean: A Clinical Analysis of 24 Cases

Byung Jun Kim; Jun Ho Choi; Sung Tack Kwon

doi:10.12790/jkssh.2017.22.1.20

Journal List > J Korean Soc Surg Hand > v.22(1) > 1106572

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Kim, Choi, and Kwon: Surgical Treatment of Axial Polysyndactyly and Postaxial Polydactyly of The Hand in Korean: A Clinical Analysis of 24 Cases

Original Article

Journal of the Korean Society for Surgery of the Hand 2017; 22(1): 20-26.

Published online: 30 March 2017

DOI: https://doi.org/10.12790/jkssh.2017.22.1.20

Surgical Treatment of Axial Polysyndactyly and Postaxial Polydactyly of The Hand in Korean: A Clinical Analysis of 24 Cases

Byung Jun Kim¹, Jun Ho Choi², Sung Tack Kwon¹

¹Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea.

²Department of Plastic and Reconstructive Surgery, Armed Forces Capital Hospital, Seongnam, Korea.

Correspondence to: Sung Tack Kwon. Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. TEL: +82-2-2072-3759, FAX: +82-2-3675-7792, stk59@snu.ac.kr

Received 5 December 2016 Revised 19 January 2017 Accepted 27 January 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Non-preaxial polydactyly of the hand refers to axial polysyndactyly involving the 2nd, 3rd, or 4th finger and postaxial polydactyly involving the 5th finger. It has a much lower incidence and a higher genetic penetrance than preaxial type.

Methods

Medical records of the patients who had operation for their polydactyly between July 1997 and July 2015 were retrospectively reviewed. The clinical data of the patients were investigated regarding demographics, clinical findings of the involved digits, foot involvement, and genetic penetrance. Through postoperative follow-up based on physical and radiologic examinations, we assessed functional and aesthetic outcomes, postoperative complications, and reoperation rate.

Results

Twenty-four patients (17 males and 7 females) underwent surgery for non-preaxial polydactyly of the hand. There were 15 postaxial type polydactyly, and 9 axial type polysyndactyly. Thirteen patients had bilateral involvement (54.2%), while 5 patients (20.8%) were right-sided and 6 patients (25%) were left-sided. In the axial type, 4th finger was the most frequently involved in 8 patients, followed by the 3rd finger in 1 patient. Thirteen patients (54.2%) had concurrent congenital foot anomalies. One patient (4.2%) had a family history of congenital hand anomaly. Patients with axial type polysyndactyly had poorer postoperative outcome than those with postaxial type, regarding reoperation rate.

Conclusion

Non-preaxial polydactyly is a very rare congenital hand anomaly and the surgical outcome is not always promising especially in the axial type. Therefore, it is necessary to provide a sufficient preoperative counseling and to perform a meticulous surgery.

Keywords: Hand deformities, Polydactyly, Syndactyly, Postoperative complications

Figures and Tables

Fig. 1

Radiologic evaluation of the patients with axial type polydactyly with syndactyly (polysyndactyly) in the bilateral 4th digits (A) and in the left 3rd finger (B).

Fig. 2

Medical photographs of the patient with postaxial polydactyly type B (A) and type A (B).

Fig. 3

Clinical analysis of the 24 patients with axial or post-axial polydactyly of the hand.

Fig. 4

Unacceptable postoperative results are shown in radiology (A) and medical photo (B) in patient with axial polydactyly.

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