Wedging osteotomy to correct metacarpal adduction for the treatment of Wassel types V and VI duplicated thumb: surgical strategy, outcomes, and anatomical findings
DOI:
https://doi.org/10.2340/jphs.v61.46296Keywords:
Thumb polydactyly, Wassel types V and VI, osteotomyAbstract
This study presents a wedge osteotomy technique for correcting metacarpal adduction in the treatment of Wassel types V and VI thumb polydactyly, evaluating its clinical efficacy and reporting intraoperative anatomical abnormalities. A retrospective analysis of 37 thumbs treated between January 2016 and June 2023 was performed. Preoperatively, the median inter-metacarpal angle (IMA) was 0°, and the median radial deviation angle of the metacarpophalangeal (MCP) joint of the ulnar thumb was 30°. All cases underwent excision of the hypoplastic radial thumb, thenar muscle relocation, and a radial closing wedge osteotomy at the base of the ulnar thumb metacarpal to achieve a corrected IMA exceeding 40°. The ulnar capsule and collateral ligament were reinforced, and one or two Z-plasties were performed to enlarge the first web space in most cases. Mean follow-up was 51.4 months (range, 12–120). Postoperative IMA and MCP joint angle improved significantly to a median of 40° (IQR: 35–42°) and 0° (IQR: 0–10°),respectively. Mean range of motion at the MCP and interphalangeal joints was 40° (IQR: 30–45°) and 60° (IQR: 45–75°). According to the modified Tada score, 31 thumbs were rated good, 5 fair, and 1 poor. In conclusion, wedge osteotomy to correct metacarpal adduction deformity in type V/VI thumb duplication yields encouraging results, with good functional outcomes and a low reoperation rate.
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Copyright (c) 2026 Zhixin Wang, Guoqing Chen, Xiaofei Tian
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