Modified Tada Score and Radiographic Axis Alignment in Radial Polydactyly

Background: Radial polydactyly is a common congenital anomaly of the thumb, often managed surgically to achieve both functional and cosmetic restoration. While various scoring systems have been used to evaluate surgical outcomes, the relationship between objective radiological correction and clinical function remains underexplored. Materials and Methods: In this retrospective study, we evaluated 32 thumbs in 27 patients who underwent surgical correction for radial polydactyly between 2013 and 2022. Wassel classification was used to categorize the duplication level. Postoperative angular correction was measured on anteroposterior radiographs by assessing the axis between the metacarpal and distal phalanx. Functional and esthetic outcomes were assessed using the modified Tada score, incorporating Horii and Tien modifications. Interobserver reliability was analyzed using the intraclass correlation coefficient (ICC). Results: The mean preoperative thumb axis was 158°, improving to 169° postoperatively, with an average correction of 11°. ICC for angular measurements was 0.91, indicating excellent reliability. Modified Tada scores were “good” in 71.8% and “fair” in 28.2% of cases, with no poor outcomes. A significant correlation was found between higher Wassel types and improved Tada scores, although angular correction did not significantly differ across types. No major postoperative complications occurred. Conclusions: Postoperative radiological correction correlates strongly with functional outcomes as assessed by the modified Tada score. Higher Wassel types may predict better functional results, suggesting that the classification system could have prognostic utility beyond morphology. This combined radiologic-functional analysis provides an objective framework for predicting outcomes in radial polydactyly.