J Korean Soc Surg Hand.  2017 Mar;22(1):20-26. 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

• Kim BJ
• Choi JH
• Kwon ST

• KMID: 2375463
• DOI: http://doi.org/10.12790/jkssh.2017.22.1.20

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.

Keyword

Hand deformities; Polydactyly; Syndactyly; Postoperative complications

MeSH Terms

Counseling
Demography
Fingers
Follow-Up Studies
Foot
Hand Deformities
Hand*
Humans
Incidence
Male
Medical Records
Penetrance
Polydactyly*
Postoperative Complications
Reoperation
Retrospective Studies
Syndactyly*

Figure

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  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).

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  Fig. 2 Medical photographs of the patient with postaxial polydactyly type B (A) and type A (B).

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  Fig. 3 Clinical analysis of the 24 patients with axial or post-axial polydactyly of the hand.

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  Fig. 4 Unacceptable postoperative results are shown in radiology (A) and medical photo (B) in patient with axial polydactyly.

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