Objective: The radial polydactyly remains the most common congenital upper limb anomaly. To correct the angulated axis of preserved thumb is still a challenge. Corrective osteotomy and eccentric tendon insertion correction has become the most adopted method in the recent years, though it brought extensive dissection. Based on the clinical experience in a tertiary center, we found soft tissue correction without corrective osteotomy could achieve acceptable functional and aesthetic outcomes in most circumstances.

Material and Methods: From 2010 to 2020, a retrospective study among 148 thumbs (33 Wassel type II, 22 type III, 93 type IV) were conducted. All the surgeries were performed by a single surgeon. Amputation with soft tissue correction only was performed except for 16 Wassel type IV, which combined with corrective osteotomy as the control cohort. The patients were examined and analyzed about the perioperative angulation and subjective outcome. The mean follow-up time was 2 years.

Results: The pre-operative metacarpophalangeal joint (MPJ) angle was 22.4 degrees on average (ranged from 6 to 53 degrees), 9.1 degrees on average (ranged from 7 to 24 degrees) postoperatively. The interphalangeal joint (IPJ) was 21 degrees on average (ranged from 15 to 51 degrees), 9 degrees on average (ranged from 7 to 11 degrees) postoperatively. In MPJ of Wassel type IV group only, the residual deformity was not statistically different between the soft tissue surgery group and osteotomy group, whether with preoperative angulation more than 20 degrees or not.

Conclusions: Among the patients with thumb duplication with joint angulation, soft tissue correction alone could provide a compatible outcome, which may decrease the procedure complexities and save operation time.

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