SURGICAL TREATMENT OF CONGENITAL TYPE V THUMB SYNDACTYLY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANGHaipeng , SUNGuangfeng , QIJianping , NIEKaiyu , JINWenhu , LIShujun , WEIZairong ,  WANGDali

Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P. R. China;

Corresponding author：

WANGDali, Email: 1290448303@qq.com

Keywords：

Type V thumb syndactyly; Hand function; Surgical procedure

DOI：

10.7507/1002-1892.20160229

Video：

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Objective To study the effectiveness of surgical treatment of congenital type V thumb syndactyly. Methods Between March 2010 and May 2015, 12 cases of congenital type V thumb syndactyly were treated. There were 7 males and 5 females, aged from 1 to 25 years (mean, 8 years). The right thumb was involved in 8 cases, and the left thumb in 4 cases. There were 2 cases of radial type, and 10 cases of ulnar type. The basement of polydactylism was far away from the carpometacarpal joint in 7 cases, and was close to the carpometacarpal joint in 5 cases (slight ulnar deviation in 1 case). X-ray films showed that the main first thumb metacarpal bone and trapezium fitted well, and 2 cases had the first metacarpal bone deformity. Preoperative individualized treatment plan was made, and polydactylism was excised by the "S" or "Z" incision and simultaneous reconstruction of thenar muscle insertions or adductor muscle insertions was performed; if necessary, wedge osteotomy was used for correction. Results All incisions healed by first intention with no complication. All cases were followed up 6 to 24 months (mean, 12 months). The thumb appearance, flexion and extension, the function of opposition, abduction function were improved significantly in 11 cases with no scar contracture deformity, small first web space, and deviation deformity. One case had slightly narrow first web space. According to hand function criterion, the results were excellent in 10 cases, good in 1 case, poor in 1 case; excellent and good rate was 91.7%. Conclusion Based on the condition of the type V thumb syndactyly, the individualized treatment plan is made, which can better restore the shape and function of the thumb.

Citation： TANGHaipeng, SUNGuangfeng, QIJianping, NIEKaiyu, JINWenhu, LIShujun, WEIZairong, WANGDali. SURGICAL TREATMENT OF CONGENITAL TYPE V THUMB SYNDACTYLY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(9): 1127-1129. doi: 10.7507/1002-1892.20160229 Copy

1.	赵磊, 齐超鹏, 江龙河.复拇指畸形分类治疗的临床疗效观察.世界最新医学信息文摘, 2016, 16(13):50.
2.	于亚东, 郭清, 邵新, 等.龙虾钳样复拇指畸形的治疗.中华手外科杂志, 2006, 22(4):223.
3.	郜永斌, 赵俊会, 田光磊, 等.重复拇指畸形的分型与治疗.中华手外科杂志, 2007, 23(5):276-278.
4.	殷耀斌, 田文, 赵俊会, 等.重复拇指畸形矫正术后继发偏斜畸形的临床研究.中国修复重建外科杂志, 2014, 28(7):835-839.
5.	潘达德, 顾玉东, 侍德, 等.中华医学会手外科学会上肢部分功能评定试用标准.中华手外科杂志, 2000, 16(3):130-135.
6.	袁伟杰.小儿复拇指畸形的治疗体会.中国继续医学教育, 2015, 7(17):131-132.
7.	魏宝富, 陈阳, 孙艳艳, 等.复拇指畸形的矫治及并发症预防.山东医药, 2005, 45(12):48-49.
8.	贾中伟, 白德明, 龙江涛, 等.儿童先天性拇指多指畸形的手术时机及方法.中华整形外科杂志, 2013, 29(5):336-340.
9.	尹军.分析手术时机选择对儿童先天性拇指多指畸形手术的效果影响.中国医学工程, 2015, 23(4):95.
10.	金成友, 奚望.小儿先天性复拇指畸形170例WASSEL分型及手术治疗.中国中西医结合儿科学, 2015, 7(6):595-597.
11.	赵炳显, 李炳万, 赵世伟, 等.特殊WasselⅥ型复拇指畸形的治疗.中国矫形外科杂志, 2011, 19(21):1828-1829.
12.	姜浩力, 庄永青, 傅小宽, 等.复拇指畸形治疗中骨关节的处理.中华手外科杂志, 2008, 24(2):101-103.
13.	张全荣, 芮永军, 薛明宇, 等.先天性Ⅵ型复拇指畸形的显微外科治疗.中华手外科杂志, 2013, 29(3):133-135.
14.	张全荣, 芮永军, 薛明宇, 等.先天性3节指骨复拇指畸形的显微组合治疗.中国矫形外科杂志, 2014, 22(23):2198-2200.
15.	Xu YL, Shen KY, Chen J, et al. Flexor pollicis longus rebalancing:a modified technique for Wassel IV-D thumb duplication. J Hand Surg (Am), 2014, 39(1):75-82.e1.
16.	Lee CC, Park HY, Yoon JO, et al. Correction of Wassel type IV thumb duplication with zigzag deformity:results of a new method of flexor pollicis longus tendon relocation. J Hand Surg (Eur Vol), 2013, 38(3):272-280.
17.	Abid A, Accadbled F, Knorr G, et al. Type IV-D thumb duplication:A new reconstruction method. Orthop Traumatol Surg Res, 2010, 96 (5):521-524.
18.	Mete BD, Altay C, Gursoy M, et al. Wassel's TypeV polydactyly with plain radiographic and CT findings. J Clin Imaging Sci, 2015, 5:16.

1. 赵磊, 齐超鹏, 江龙河.复拇指畸形分类治疗的临床疗效观察.世界最新医学信息文摘, 2016, 16(13):50.
2. 于亚东, 郭清, 邵新, 等.龙虾钳样复拇指畸形的治疗.中华手外科杂志, 2006, 22(4):223.
3. 郜永斌, 赵俊会, 田光磊, 等.重复拇指畸形的分型与治疗.中华手外科杂志, 2007, 23(5):276-278.
4. 殷耀斌, 田文, 赵俊会, 等.重复拇指畸形矫正术后继发偏斜畸形的临床研究.中国修复重建外科杂志, 2014, 28(7):835-839.
5. 潘达德, 顾玉东, 侍德, 等.中华医学会手外科学会上肢部分功能评定试用标准.中华手外科杂志, 2000, 16(3):130-135.
6. 袁伟杰.小儿复拇指畸形的治疗体会.中国继续医学教育, 2015, 7(17):131-132.
7. 魏宝富, 陈阳, 孙艳艳, 等.复拇指畸形的矫治及并发症预防.山东医药, 2005, 45(12):48-49.
8. 贾中伟, 白德明, 龙江涛, 等.儿童先天性拇指多指畸形的手术时机及方法.中华整形外科杂志, 2013, 29(5):336-340.
9. 尹军.分析手术时机选择对儿童先天性拇指多指畸形手术的效果影响.中国医学工程, 2015, 23(4):95.
10. 金成友, 奚望.小儿先天性复拇指畸形170例WASSEL分型及手术治疗.中国中西医结合儿科学, 2015, 7(6):595-597.
11. 赵炳显, 李炳万, 赵世伟, 等.特殊WasselⅥ型复拇指畸形的治疗.中国矫形外科杂志, 2011, 19(21):1828-1829.
12. 姜浩力, 庄永青, 傅小宽, 等.复拇指畸形治疗中骨关节的处理.中华手外科杂志, 2008, 24(2):101-103.
13. 张全荣, 芮永军, 薛明宇, 等.先天性Ⅵ型复拇指畸形的显微外科治疗.中华手外科杂志, 2013, 29(3):133-135.
14. 张全荣, 芮永军, 薛明宇, 等.先天性3节指骨复拇指畸形的显微组合治疗.中国矫形外科杂志, 2014, 22(23):2198-2200.
15. Xu YL, Shen KY, Chen J, et al. Flexor pollicis longus rebalancing:a modified technique for Wassel IV-D thumb duplication. J Hand Surg (Am), 2014, 39(1):75-82.e1.
16. Lee CC, Park HY, Yoon JO, et al. Correction of Wassel type IV thumb duplication with zigzag deformity:results of a new method of flexor pollicis longus tendon relocation. J Hand Surg (Eur Vol), 2013, 38(3):272-280.
17. Abid A, Accadbled F, Knorr G, et al. Type IV-D thumb duplication:A new reconstruction method. Orthop Traumatol Surg Res, 2010, 96 (5):521-524.
18. Mete BD, Altay C, Gursoy M, et al. Wassel's TypeV polydactyly with plain radiographic and CT findings. J Clin Imaging Sci, 2015, 5:16.

Chinese Journal of Reparative and Reconstructive Surgery

SURGICAL TREATMENT OF CONGENITAL TYPE V THUMB SYNDACTYLY

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