Case Report

Correction of Triphalangeal Thumb with Small Delta Phalanx by Closed Wedge Osteotomy of the Proximal Phalanx: A Case Report

Abstract

Background: Triphalangeal thumb (TPT) is a rare congenital anomaly, especially in the 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.
Case Report: In this study, we report a case of right TPT with a small delta phalanx in a nine-year-old boy who was treated by proximal phalanx radial closed wedge osteotomy without delta phalanx resection or intracapsular dissection. The angular deformity and the appearance of the thumb were corrected by this simple procedure without resulting in instability and stiffness in the interphalangeal joint.
Conclusion: Proximal phalanx closed wedge osteotomy is a rapid, simple, and effective technique with a low risk of unexpected complications for correcting the appearance in the cases of TPT with a small delta phalanx.

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 Plast Surg Hand Surg. 2015;2(1):12-4. doi: 10.3109/23320885.2014.997236. [PubMed: 27252959]. [PubMed Central: PMC4623540].
2. Finsterwald M, Guenkel S. A rare case of thumb polydactyly with metacarpophalangeal joint synostosis. Case Reports Plast Surg Hand Surg. 2019;6(1):121-4. doi: 10.1080/23320885.2019.1596032. [PubMed: 32002458]. [PubMed Central: PMC6968632].
3. Nietosvaara NN, Sommarhem AJ, Puhakka JM, Tan RES, Schalamon J, Nietosvaara AY. Appearance of congenital hand anomalies. Scand J Surg. 2021;110(3):434-40. doi: 10.1177/1457496920903987. [PubMed: 32106765]. [PubMed Central: PMC8551435].
4. Jalili A, Najd MF. 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. [PubMed: 25664282]. [PubMed Central: PMC4301241].
5. Akhlaghdoust M, Zarbati N, Chaichian S, Saberi SH, Mohammadkhani N, Asami M, et al. A rare triploidy case with long term survival: A case report study. Iran Red Crescent Med J. 2017;19(7):1-6. doi: 10.5812/ircmj.55573.
6. Alrabai HM, Farr S, Girsch W. Triphalangeal thumb reduction osteotomy through a versatile spiral approach. Tech Hand Up Extrem Surg. 2016;20(2):54-60. doi: 10.1097/BTH.0000000000000115. [PubMed: 26926846].
7. Hovius SER, Potuijt JWP, van Nieuwenhoven CA. Triphalangeal thumb: Clinical features and treatment. J Hand Surg Eur Vol. 2019;44(1):69-79. doi: 10.1177/1753193418797922. [PubMed: 30223699]. [PubMed Central: PMC6297898].
8. Gousheh J, Arasteh E. Isolated bilateral triphalangeal thumb with delta phalanx: A case report. World J Plast Surg. 2013;2(2):111-4. [PubMed: 25489514]. [PubMed Central: PMC4238344].9. Wolfe SW, Pederson WC, Kozin SH. Wolfe SW, Pederson WC, Hotchkiss RN, et al. Green's operative hand surgery. Philadelphia, PA: Elsevier Health Sciences; 2010.
10. Zuidam JM, Selles RW, de KM, Hovius SE. Outcome of two types of surgical correction of the extra phalanx in triphalangeal thumb: Is there a difference? J Hand Surg Eur Vol. 2016;41(3):253-7. doi: 10.1177/1753193415576459. [PubMed: 25794887].
11. Johnson JM, Higgins TJ, Lemos D. Appearance of the delta phalanx (longitudinally bracketed epiphysis) with MR imaging.Pediatr Radiol. 2011;41(3):394-6. doi: 10.1007/s00247-010-1863-8. [PubMed: 20972673].
12. Peimer CA. Combined reduction osteotomy for triphalangeal thumb. J Hand Surg Am. 1985;10(3):376-81. doi: 10.1016/s0363- 5023(85)80038-1. [PubMed: 3998419].
13. Wang AA, Hutchinson DT. Results of treatment of delta triphalangeal thumbs by excision of the extra phalanx. J Pediatr Orthop. 2015;35(5):474-7. doi: 10.1097/BPO.0000000000000319. [PubMed: 25264557].
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IssueVol 10 No 3 (2024) QRcode
SectionCase Report
DOI https://doi.org/10.18502/jost.v10i3.16784
Keywords
Osteotomy Finger Phalanges Hand Deformities Congenital Abnormalities
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How to Cite
1.
Okhovatpour MA, Adibi A. Correction of Triphalangeal Thumb with Small Delta Phalanx by Closed Wedge Osteotomy of the Proximal Phalanx: A Case Report. J Orthop Spine Trauma. 2024;10(3):124-6.