Surgical strategy for polydactyly of the thumb

Polydactyly of the thumb, radial polydactyly, or preaxial polydactyly is common in all races, and about 20 percent of them occur bilaterally. Patients with polydactyly of the thumb show very diverse manifestations, from a rudimentary floating type to a complex one. The goal of surgical reconstruction is to make a straight, mobile, and stable thumb of good appearance in size and shape. The simple ablation of one digit has not produced satisfactory outcomes in most cases of polydactyly of the thumb, and resulted in retained deviation, stiffness and/or ligamentous instability of the thumb. Surgical concepts and techniques are still evolving. However, there are several reconstructive strategies to achieve a functionally and cosmetically acceptable thumb.