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Arch Hand Microsurg > Volume 22(1); 2017 > Article
Journal of the Korean Society for Surgery of the Hand 2017;22(1):20-26.
Published online March 31, 2017.
DOI: https://doi.org/10.12790/jkssh.2017.22.1.20   
Surgical Treatment of Axial Polysyndactyly and Postaxial Polydactyly of The Hand in Korean: A Clinical Analysis of 24 Cases
Byung Jun Kim, Jun Ho Choi, Sung Tack Kwon
1Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. stk59@snu.ac.kr
2Department of Plastic and Reconstructive Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
Received: 5 December 2016   • Revised: 19 January 2017   • Accepted: 27 January 2017
Abstract
Purpose
Non-preaxial polydactyly of the hand refers to axial polysyndactyly involving the 2nd, 3rd, or 4th finger and postaxial polydactyly involving the 5th finger. It has a much lower incidence and a higher genetic penetrance than preaxial type.

Methods
Medical records of the patients who had operation for their polydactyly between July 1997 and July 2015 were retrospectively reviewed. The clinical data of the patients were investigated regarding demographics, clinical findings of the involved digits, foot involvement, and genetic penetrance. Through postoperative follow-up based on physical and radiologic examinations, we assessed functional and aesthetic outcomes, postoperative complications, and reoperation rate.

Results
Twenty-four patients (17 males and 7 females) underwent surgery for non-preaxial polydactyly of the hand. There were 15 postaxial type polydactyly, and 9 axial type polysyndactyly. Thirteen patients had bilateral involvement (54.2%), while 5 patients (20.8%) were right-sided and 6 patients (25%) were left-sided. In the axial type, 4th finger was the most frequently involved in 8 patients, followed by the 3rd finger in 1 patient. Thirteen patients (54.2%) had concurrent congenital foot anomalies. One patient (4.2%) had a family history of congenital hand anomaly. Patients with axial type polysyndactyly had poorer postoperative outcome than those with postaxial type, regarding reoperation rate.

Conclusion
Non-preaxial polydactyly is a very rare congenital hand anomaly and the surgical outcome is not always promising especially in the axial type. Therefore, it is necessary to provide a sufficient preoperative counseling and to perform a meticulous surgery.
 
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