Introduction
Wassel Type IV is a common congenital hand anomaly characterized by duplication of the proximal phalanges at the metacarpophalangeal joint. The objective of thumb polydactyly reconstruction is to achieve a functional thumb with adequate motion, natural width and length, and stable metacarpophalangeal and interphalangeal joints. This retrospective study compared the use of K-wire fixation versus non-K-wire fixation in the surgical treatment of Wassel Type IV polydactyly.
Patients and Method
The study included 77 radial polydactyly thumbs in 75 patients with Wassel Type IV polydactyly who underwent surgical treatment from April 2011 to July 2021. Surgical procedures, including tendon transfer, tissue augmentation, and the use of K-wire fixation, were evaluated. Outcomes were assessed through various measurements, including the TADA score classification, post-operative x-rays, and range of motion assessments. Complications such as pin tract infection, migration, and maceration were also recorded.
Results
The results showed no significant difference in functional outcomes based on the TADA classification between the K-wire fixation group and the non-K-wire fixation group. Over 70% of patients achieved good outcomes in both groups. However, a significantly higher rate of tissue augmentation was observed in the K-wire fixation group, indicating more severe deformity presentation in cases of radial polydactyly. Complications associated with K-wire fixation, including pin tract infection (7.9%), migration (11.1%), and maceration (4.8%), were identified.
Conclusion
In this retrospective study comparing K-wire fixation versus non-K-wire fixation for the surgical treatment of Wassel Type IV polydactyly, both approaches yielded favorable functional outcomes according to the TADA classification. However, complications such as pin tract infection, migration, and maceration were observed in the K-wire fixation group, underscoring the significance of carefully considering these potential risks.

Download