Surgical excision of pedunculated supernumerary digits prevents traumatic amputation neuromas.
Nine patients divided into two groups were treated for pedunculated supernumerary digits or their sequelae. The first group consisted of three patients who had among them five traumatic amputation neuromas. In each case these lesions resulted from primary suture ligation of accessory digits in infancy. Secondary surgical excision of the vestigial digit with high ligation and retraction of the accompanying nerve tissue was required in all cases. The second group consisted of six patients who had 12 pedunculated supernumerary digits. Primary surgical excision of these digits was performed with high transection and retraction of the accompanying accessory digital nerve. All patients in this group had excellent cosmetic results with no postoperative neuroma formation. Adult family members who had undergone suture ligation of similar supernumerary digits in infancy accompanied seven of the nine patients in this series. On careful examination, each of these family members had signs and symptoms attributable to traumatic amputation neuromas. We feel identification and high transection of the accessory digital nerve is essential in the treatment of pedunculated supernumerary digits. This treatment prevents traumatic amputation neuromas and yields a better cosmetic result than the traditional method of suture ligation in infancy.
Leber
Geoffrey E
GE
Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
Gosain
Arun K
AK
D000293:Adolescent; D000673:Amputation, Traumatic; D001707:Biopsy, Needle; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000002:abnormalities*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008026:Ligation / Q000379:methods; D008297:Male; D017169:Neoplasms, Post-Traumatic / Q000473:pathology / Q000517:prevention & control*; D009463:Neuroma / Q000473:pathology / Q000517:prevention & control*; D017689:Polydactyly / Q000175:diagnosis / Q000601:surgery*; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome