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.	?趙磊, 齊超鵬, 江龍河.復拇指畸形分類治療的臨床療效觀察.世界最新醫學信息文摘, 2016, 16(13):50.
2.	于亞東, 郭清, 邵新, 等.龍蝦鉗樣復拇指畸形的治療.中華手外科雜志, 2006, 22(4):223.
3.	郜永斌, 趙俊會, 田光磊, 等.重復拇指畸形的分型與治療.中華手外科雜志, 2007, 23(5):276-278.
4.	殷耀斌, 田文, 趙俊會, 等.重復拇指畸形矯正術后繼發偏斜畸形的臨床研究.中國修復重建外科雜志, 2014, 28(7):835-839.
5.	潘達德, 顧玉東, 侍德, 等.中華醫學會手外科學會上肢部分功能評定試用標準.中華手外科雜志, 2000, 16(3):130-135.
6.	袁偉杰.小兒復拇指畸形的治療體會.中國繼續醫學教育, 2015, 7(17):131-132.
7.	魏寶富, 陳陽, 孫艷艷, 等.復拇指畸形的矯治及并發癥預防.山東醫藥, 2005, 45(12):48-49.
8.	賈中偉, 白德明, 龍江濤, 等.兒童先天性拇指多指畸形的手術時機及方法.中華整形外科雜志, 2013, 29(5):336-340.
9.	尹軍.分析手術時機選擇對兒童先天性拇指多指畸形手術的效果影響.中國醫學工程, 2015, 23(4):95.
10.	金成友, 奚望.小兒先天性復拇指畸形170例WASSEL分型及手術治療.中國中西醫結合兒科學, 2015, 7(6):595-597.
11.	趙炳顯, 李炳萬, 趙世偉, 等.特殊WasselⅥ型復拇指畸形的治療.中國矯形外科雜志, 2011, 19(21):1828-1829.
12.	姜浩力, 莊永青, 傅小寬, 等.復拇指畸形治療中骨關節的處理.中華手外科雜志, 2008, 24(2):101-103.
13.	張全榮, 芮永軍, 薛明宇, 等.先天性Ⅵ型復拇指畸形的顯微外科治療.中華手外科雜志, 2013, 29(3):133-135.
14.	張全榮, 芮永軍, 薛明宇, 等.先天性3節指骨復拇指畸形的顯微組合治療.中國矯形外科雜志, 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. ?趙磊, 齊超鵬, 江龍河.復拇指畸形分類治療的臨床療效觀察.世界最新醫學信息文摘, 2016, 16(13):50.
2. 于亞東, 郭清, 邵新, 等.龍蝦鉗樣復拇指畸形的治療.中華手外科雜志, 2006, 22(4):223.
3. 郜永斌, 趙俊會, 田光磊, 等.重復拇指畸形的分型與治療.中華手外科雜志, 2007, 23(5):276-278.
4. 殷耀斌, 田文, 趙俊會, 等.重復拇指畸形矯正術后繼發偏斜畸形的臨床研究.中國修復重建外科雜志, 2014, 28(7):835-839.
5. 潘達德, 顧玉東, 侍德, 等.中華醫學會手外科學會上肢部分功能評定試用標準.中華手外科雜志, 2000, 16(3):130-135.
6. 袁偉杰.小兒復拇指畸形的治療體會.中國繼續醫學教育, 2015, 7(17):131-132.
7. 魏寶富, 陳陽, 孫艷艷, 等.復拇指畸形的矯治及并發癥預防.山東醫藥, 2005, 45(12):48-49.
8. 賈中偉, 白德明, 龍江濤, 等.兒童先天性拇指多指畸形的手術時機及方法.中華整形外科雜志, 2013, 29(5):336-340.
9. 尹軍.分析手術時機選擇對兒童先天性拇指多指畸形手術的效果影響.中國醫學工程, 2015, 23(4):95.
10. 金成友, 奚望.小兒先天性復拇指畸形170例WASSEL分型及手術治療.中國中西醫結合兒科學, 2015, 7(6):595-597.
11. 趙炳顯, 李炳萬, 趙世偉, 等.特殊WasselⅥ型復拇指畸形的治療.中國矯形外科雜志, 2011, 19(21):1828-1829.
12. 姜浩力, 莊永青, 傅小寬, 等.復拇指畸形治療中骨關節的處理.中華手外科雜志, 2008, 24(2):101-103.
13. 張全榮, 芮永軍, 薛明宇, 等.先天性Ⅵ型復拇指畸形的顯微外科治療.中華手外科雜志, 2013, 29(3):133-135.
14. 張全榮, 芮永軍, 薛明宇, 等.先天性3節指骨復拇指畸形的顯微組合治療.中國矯形外科雜志, 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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