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Preaxial duplication R. Sh. Kamrani 90/2/20

Preaxial duplication R. Sh. Kamrani 90/2/20. Incidence 1-2% of neonate with congenital anomaly 10% with upper extremity anomaly. Incidence Most common polyductyly in Whites and Asians Second common anomaly in hand 1/3000 birth Usually Unilateral Sporadic Without other syndromes .

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Preaxial duplication R. Sh. Kamrani 90/2/20

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  1. Preaxial duplication R. Sh. Kamrani 90/2/20

  2. Incidence • 1-2% of neonate with congenital anomaly • 10% with upper extremity anomaly

  3. Incidence • Most common polyductyly in Whites and Asians • Second common anomaly in hand • 1/3000 birth • Usually • Unilateral • Sporadic • Without other syndromes

  4. Classification • Wassel

  5. Clinical • Widening of the tip to two complete thumb rays • Hypoplasia (radial side more hypoplastic) • Convergent or divergent • Flat hand • Deviate or delta phalanx

  6. Treatment • Surgery • Indication • Cosmetic • Function • Age of surgery • 6-12-18 m. • <5 y. • 8-10 y. for revision • Kinds of surgery

  7. Treatment • Preoperative splinting • Kinds of surgery • Simple excision • Bilhaut-Cloquet • Excision and lig. Reconstruction

  8. Treatment • Bilaut-Cloquet • Meticulous physeal rearrangement

  9. Excision and reconstruction • Which thumb

  10. Steps of reconstruction

  11. ???

  12. Thank you for your attention

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