Hypertrophy of the Metacarpal Head after Operation of Preaxial Polydactyly at the Metacarpophalangeal Joint

Journal of the Korean Society for Surgery of the Hand 2006;11(2):105-110.
Published online June 1, 2006.

Sanglim Lee, Moon Sang Chung, Hyun Sik Gong, Young Ho Lee, Ji Hyung Kim, Ki Hyuk Seong, Jin Young Kim, Goo Hyun Baek

중수지 관절에서 중복된 무지 다지증의 수술 후 발생한 중수골 두의 비대

이상림, 정문상, 공현식, 이영호, 김지형, 성기혁, 김진영, 백구현

Abstract

Purpose
To evaluate the incidence and the risk factors of bony hypertrophy of metacarpal head after the operative treatment of the preaxial polydactyly duplicated at the metacarpophalangeal joint. Materials and Methods: Twenty two thumbs of unilateral preaxial polydactyly at the metacarpophalangeal joint were followed up for average 5.1 years after operation. Excision of extra digit and reconstruction of soft tissues were performed in sixteen patients and modified Bilhaut procedure was performed in six cases. If the postoperative diameter ratio of the metacarpal head to the normal side increased 20% over the preoperative one, it was considered hypertrophic metacarpal head. Results: Four out of 22 thumbs showed hypertrophic metacarpal head. The average age of four hypertrophic patients at the operation was 35.8 months and was 18.1 months in non-hypertrophic group. Three out of six thumbs with modified Bilhaut procedure and one out of 16 ones with excision and reconstruction procedure became to have hypertrophic metacarpal head. Conclusion: The thumb will be like to have the hypertrophic metacarpal head when the age at the operation is higher or when modified Bilhaut procedure is performed.