An On-Top-Plasty Reconstruction for Complicated Radial Polydactyly

Background: The clinical presentation of radial polydactyly can vary greatly. Careful planning and appreciation of the anatomic subtleties provides alternative surgical options to improve patient outcomes. Methods: We present a case of a well-formed accessory web space thumb and a hypoplastic primary thumb. Results: Rather than excising the accessory digit, we performed a spare-part, on-top-plasty reconstruction to replace the diminutive distal phalanx of the primary thumb. Conclusions: This novel case applied the principle of spare-part surgery to reconstruct a more aesthetic and functional reconstructed digit.