Surgical reconstruction in Wassel type IV thumb duplication

Objective: The aim of this study was to review the results of patients with Wassel type IV thumbduplication, treated with a single reconstructive procedure. Methods: The mean follow–up period was 76.9 months. Objective assessments were carried out using Horii modification of Tada scoring system and ALURRA scoring system. Thumb length, thumb girth, range of motion of metacarpophalangeal (MCP) and interphalangeal (IP) joints and angular deformities at MCP and IP joints were evaluated. Results: The mean ALURRA score was 21 (range; 16–24) and Tada Score 5.25 (range; 2–7). The length of the operated thumb was approximately 95%, the girth 89% and nail width 80% of the non– operated side. The mean range of motion was 75.1% of the unaffected thumb in interphalangeal joint and 80.1% in metacarpophalangeal joint. Metacarpophalangeal joint malalignment had shown statistically significant negative correlation with the scores of Tada, ALURRA and VAS. Conclusion: Surgical reconstruction may provide a functional and stable thumb in Wassel type IV thumb duplications. The satisfaction of patients is affected by angular deformity of thumbs and cosmetic outlook.