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Duplication of distal phalanx

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Partial or complete duplication of the thumb distal phalanx can be treated in several ways:

  • if the ulnar digit is dominant:
    • smaller radial digit is removed
    • head of the proximal phalanx may require contouring if the distal phalanx is completely duplicated
    • radial collateral ligament is repaired
  • if the radial digit is dominant:
    • less frequent scenario
    • the ulnar-sided digit is removed and the ulnar collateral ligament is repaired
  • if both digits are of similar size:
    • the ulnar thumb with the ulnar collateral ligament can be preserved; the bone from the smaller digit is excised but the residual soft tissue can be used to augment the ulnar thumb
    • alternatively, the Bilhaut-Cloquet procedure may be used:
      • both thumbs are divided into equal halves
      • the two halves nearest each other are discarded
      • the outer portions of each thumb are combined to create a new thumb
      • tends to give problems with cosmesis (central nail split, broad thumb) and function (stiffness)

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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