Background: Given the rare occurrence, there is a paucity of literature characterizing surgical management of Wassel Type I thumb duplications, especially at an older age where psychosocial factors become a more significant consideration.
Case Presentation: We present a 5-year-old girl with right Wassel Type I thumb duplication with delayed initial presentation for treatment. We performed a modified Wassel Type I radial thumb ablation, percutaneous pinning, and nail reconstruction preserving radial nail fold and transferring to ulnar nail plate and fold.
Conclusions: This modified approach maximizes functional and aesthetic outcomes and highlights the significance of considering surgical management to improve quality of life in delayed presentations of Wassel Type I thumb duplication.
Keywords: Thumb duplication; Wassel Type I thumb; thumb reconstruction; congenital hand surgery; pediatric hand surgery