Radiographic Characteristics of the Triphalangeal Thumb in Patients With Congenital Thumb Duplication: An Analysis of 383 Thumbs in 368 Children

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-03-01 DOI:10.1016/j.jhsa.2024.11.004

JianPing Wu MD , Hai Zhao MD , ChenYang Li BD , YuanZhong Liu MD , Federico Canavese PhD , HongWen Xu PhD

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引用次数: 0

Abstract

Purpose

The purpose of this study was to evaluate the morphologic and radiographic characteristics of the triphalangeal thumb (TPT) in patients with congenital thumb duplication.

Methods

We retrospectively reviewed 368 children with TPT duplication (n = 383). Data on age, sex, and laterality were obtained from medical records. The morphologic and radiographic characteristics of the TPT duplication were evaluated using plain radiographs.

Results

Of the 383 fingers, 322 (84%) had a TPT duplication on the radial side, 36 (10%), on the ulnar side, and 25 (7%) were bilateral. The mean age at the time of surgery of TPT duplication on the radial side (21 ± 11 months), on the ulnar side (25 ± 15 months), and in bilateral cases (27 ± 15 months) was not significantly different. The extra thumb was connected to the main thumb by a joint (75%), bone (18%), soft tissue (6%), and epiphysis (1%). There were 26 cases (7%) of abnormal hypertrophic epiphysis of the main thumb, all of which were located in the distal phalanx of the radial side of the TPT duplications. The thumb epiphyses in patients with TPT duplication appeared in the following order: distal phalanx (mean, 24 ± 14 months; range, 7–94 months), proximal phalanx (mean, 31 ± 18 months; range, 14–94 months), and metacarpal (mean, 34 ± 20 months; range, 13–94 months).

Conclusions

Triphalangeal thumb in patients with congenital thumb duplication is more common in boys, often duplicated at the level of the proximal phalanx, with the extra thumb articulated to the main thumb by a joint, often unilateral, and frequently radial and right-sided. The epiphysis of the TPT duplication ossifies sequentially from the distal phalanx to the metacarpal, and its onset is delayed in comparison to normal children.

Type of study/level of evidence

Diagnostic III.

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368例小儿383根拇指的x线特征分析。

目的：本研究的目的是评估先天性拇指重复患者三指指（TPT）的形态学和影像学特征。方法：对368例TPT重复患儿（n = 383）进行回顾性分析。年龄、性别和侧位数据来自医疗记录。使用x线平片评估TPT复制的形态学和影像学特征。结果：383个手指中，322个（84%）在桡侧有TPT重复，36个（10%）在尺侧，25个（7%）在双侧。桡骨侧（21±11个月）、尺侧（25±15个月）、双侧（27±15个月）TPT重复手术时的平均年龄差异无统计学意义。多余的拇指通过关节（75%）、骨骼（18%）、软组织（6%）和骨骺（1%）连接到主拇指。主拇指异常增生性骨骺26例（7%），均位于TPT双侧桡侧远端指骨。TPT重复患者拇指骺端依次出现：远端指骨(平均24±14个月；范围，7-94个月)，近端指骨(平均，31±18个月；范围，14-94个月)，掌骨(平均，34±20个月；范围：13-94个月)。结论：先天性拇指三指畸形多见于男孩，多发生在近端指骨水平，多指通过关节与主拇指关节连接，多为单侧，多为桡侧和右侧。TPT重复骨骺从远端指骨到掌骨依次骨化，与正常儿童相比，其发病延迟。研究类型/证据水平：诊断III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.