In response to Letter to the Editor regarding: Prognostic value of age and Wassel classification in the reconstruction of thumb duplication. J Child Orthop (2013)7:551–557

Even assuming that the youngest group had their final follow-up at a younger age than the rest of the groups, which also may be the reason there were fewer complications in this group, it would not contradict the fact that there was a progressive increase in the number of complications in Wassel groups II–IV (with the difference being statistically significant, p = 0.0002). [...]the different numbers of complications that occur in patients of older or younger ages at follow-up did not depend on differences at 5 months of follow-up but over longer periods of time in accordance with growth spurts, damage to or asymmetrical joints and bone, or tendon imbalance, as the authors of the Letter to the Editor mention. [...]we agree that an aesthetic consideration should be added to whatever different system we use in the future.