Case Report

Correction of Triphalangeal Thumb with a Small Delta Phalanx by Proximal Phalanx Closed Wedge Osteotomy

Abstract

Triphalangeal thumb is a rare congenital anomaly especially in Asian population. Traditional treatments depend on the type of deformity and the presence of concomitant anomalies and include either excision in addition to the ligament reconstruction or fusion and shortening osteotomy. Instability and stiffness are the major concerns following the traditional techniques. In this study, we report a case of right triphalangeal thumb with a small delta phalanx in a nine-year-old boy that was treated by proximal phalanx radial closed wedge osteotomy without delta phalanx resection and intracapsular dissection. The angular deformity and the appearance of the thumb was corrected by this simple procedure without resulting in instability and stiffness in the interphalangeal  joint.

1. Iba K, Wada T, Yamashita T. Correction of thumb angulations after physiolysis of delta phalanges in a child with Rubinstein–Taybi syndrome: a case report. Case Reports in Plastic Surgery and Hand Surgery. 2015 Jan 1;2(1):12-4.
2. Finsterwald M, Guenkel S. A rare case of thumb polydactyly with metacarpophalangeal joint synostosis. Case Reports in Plastic Surgery and Hand Surgery. 2019 Jan 1;6(1):121-4.
3. Nietosvaara N, Sommarhem A, Puhakka J, Tan R, Schalamon J, Nietosvaara A. Appearance of Congenital Hand Anomalies. Scandinavian Journal of Surgery. 2020:1457496920903987.
4. Jalili A, Najd Mazhar F. An unusual case of radial polydactyly, (tetraplication of the thumb, duplication of the radial carpal bones and bifurcation of the radius). Med J Islam Repub Iran. 2014;28:81.
5. Akhlaghdoust M, Zarbati N, Chaichian S, Saberi SH, Mohammadkhani N, Asami M, Hadipour F, Hadipour Z, Shafeghati Y, Nikfar B, Vasei N. A Rare Triploidy Case with Long Term Survival: A Case Report Study. Iranian Red Crescent Medical Journal. 2017 Jul;19(7).
6. Alrabai HM, Farr S, Girsch W. Triphalangeal Thumb Reduction Osteotomy Through a Versatile Spiral Approach. Techniques in hand & upper extremity surgery. 2016 Jun 1;20(2):54-60.
7. Hovius SE, Potuijt JW, van Nieuwenhoven CA. Triphalangeal thumb: clinical features and treatment. Journal of Hand Surgery (European Volume). 2019 Jan;44(1):69-79.
8. Gousheh J, Arasteh E. Isolated bilateral triphalangeal thumb with delta phalanx: a case report. World journal of plastic surgery. 2013;2(2):111.
9. Wolfe SW, Pederson WC, Hotchkiss RN, Kozin SH, Cohen MS. Green's operative hand surgery: the pediatric hand E-book. Elsevier Health Sciences; 2010 Nov 24.
10. Zuidam JM, Selles RW, de Kraker M, Hovius SE. Outcome of two types of surgical correction of the extra phalanx in triphalangeal thumb: is there a difference?. Journal of Hand Surgery (European Volume). 2016 Mar;41(3):253-7.
11. Johnson JM, Higgins TJ, Lemos D. Appearance of the delta phalanx (longitudinally bracketed epiphysis) with MR imaging. Pediatric radiology. 2011 Mar 1;41(3):394-6.
12. Peimer CA. Combined reduction osteotomy for triphalangeal thumb. The Journal of hand surgery. 1985 May 1;10(3):376-81.
13. Wang AA, Hutchinson DT. Results of treatment of delta triphalangeal thumbs by excision of the extra phalanx. Journal of Pediatric Orthopaedics. 2015 Jul 1;35(5):474-7.
Files
IssueVol 10 No 3 (2024) QRcode
SectionCase Report
DOI https://doi.org/10.18502/jost.v10i3.16784
Keywords
Triphalangeal Thumb Hand Deformities Congenital Osteotomy Finger Phalanges
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Okhovatpour MA, Adibi A. Correction of Triphalangeal Thumb with a Small Delta Phalanx by Proximal Phalanx Closed Wedge Osteotomy. J Orthop Spine Trauma. 2024;10(3):124-6.