Wassel classification – Knowledge and References

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Congenital Hand

Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022

Radial polydactyly is documented in high proportions in Native American and Asian populations [35]. Most cases are unilateral, sporadic and without systemic problems [36]. The Wassel classification is most widely used, although the true nature of the thumbs is usually not apparent because the skeletons are immature in the children. Wassel type IV is the most common type and recently subtyped into type IVA (hypoplastic type), IVB (ulnar deviated type), IVC (divergent type) and IVD (convergent type) [37]. A radially deviated type should be also considered [38]. In triplicate digit, a rare type of polydactyly, the most developed proximal components and most developed distal components are often in different rays, therefore the ray transfer is needed for the surgery [39].

A rare case of thumb polydactyly with metacarpophalangeal joint synostosis

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Journal Information

Published in Case Reports in Plastic Surgery and Hand Surgery, 2019

Michael Finsterwald, Sebastian Guenkel

Even though thumb polydactyly is the most common form of polydactyly in the hand, these cases cannot be classified in the widely used classification by Wassel [4]. Of the multiple modifications of Wassels description, the Rotterdam classification by Zuidam et al [5] is the most complete including bony separation into the carpal bones, thumb triplication as well as synostosis and symphalangism. In a study by Dijkman et al [15], of 520 thumb polydactyly patients only 60% could be classified by the Wassel classification in comparison to 100% by the Rotterdam classification. According to it, our presented case would be classified as Type IV S (symphalangism) u (ulnar).