Diagnosis and treatment of thumb polydactyly with symphalangism in children_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SHEN Xiaofang , YIN Fei ,  RUI Yongjun , LIN Weifeng , LIU Shuai , YU Jiong

Department of Pediatric Orthopaedics, Wuxi No.9 People’s Hospital Affiliated to Soochow University, the Orthopaedic Hospital of Wuxi, Wuxi Jiangsu, 214000, P.R.China;

Corresponding?author：

RUI Yongjun, Email: ruiyj@hotmail.com

Keywords：

Thumb polydactyly with symphalangism; congenital malformation; ligament reconstruction; internal fixation; children

DOI：

10.7507/1002-1892.201803006

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ObjectiveTo investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children.MethodsSeven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3.1 years. The thumb-polydactyly was diagnosed with MRI and it was seen that the base of radial multi-finger and the proximal phalangeal joint were connected by cartilage. All patients were treated with resection, lateral collateral ligament reconstruction, bone osteotomy and internal fixation.ResultsThe operation was successfully completed, and there was no early complications such as infection and flap necrosis. All patients were followed up 6-23 months (mean, 14.1 months). At last follow-up, there was no deformity finger, scar contracture, and other complications. The extension of the interphalangeal joint was no limited, and the flexion range of the interphalangeal joint was 20-75° (mean, 56.7°). The appearance and function of the thumb was rated as excellent in 3 cases and good in 4 cases by Japanese Society for Surgery of the Hand (JSSH) scoring, with the excellent and good rate of 100%.ConclusionThe thumb polydactyly with symphalangism in children can be combined with clinical manifestations, X-ray film, and MRI examination to diagnose, and can obtain satisfactory results through the reconstruction of lateral collateral ligament, bone osteotomy, and internal fixation.

Citation： SHEN Xiaofang, YIN Fei, RUI Yongjun, LIN Weifeng, LIU Shuai, YU Jiong. Diagnosis and treatment of thumb polydactyly with symphalangism in children. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(10): 1317-1320. doi: 10.7507/1002-1892.201803006 Copy

1.	Al-Aithan B, Al-Blaihed L, Mahmoud S, et al. Thumb polydactyly with symphalangism. J Hand Surg (Br), 2005, 30(4): 346-349.
2.	高偉陽, 王安遠, 丁健, 等. 末節先天復拇畸形的分型和術式選擇. 中華整形外科雜志, 2014, 30(5): 330-335.
3.	Dijkman RR, van Nieuwenhoven CA, Selles RW, et al. Comparison of functional outcome scores in radial polydactyly. J Bone Joint Surg (Am), 2014, 96(6): 463-470.
4.	Wassel HD. The results of surgery for polydactyly of the thumb. A review. Clin Orthop Relat Res, 1969, 64: 175-193.
5.	Zuidam JM, Selles RW, Ananta M, et al. A classification system of radial polydactyly: inclusion of triphalangeal thumb and triplication. J Hand Surg (Am), 2008, 33(3): 373-377.
6.	Takagi R, Kawabata H, Matsui Y. Thumb polydactyly with symphalangism in young children. J Hand Surg (Eur Vol), 2009, 34(6): 800-804.
7.	鐘文耀, 田文. 橈側多指畸形的影像學分型. 中國骨與關節雜志, 2017, 6(4): 301-304.
8.	陳時益, 高偉陽, 李俊杰, 等. MRI與關節鏡在診斷三角纖維軟骨復合體損傷中的差異及原因分析. 中華手外科雜志, 2015, 31(1): 34-37.
9.	黃碩, 谷文光, 李朋, 等. 前交叉韌帶損傷后膝關節半月板和軟骨的MRI定量分析研究進展. 中國矯形外科雜志, 2015, 23(14): 1291-1294.
10.	李顯, 趙力, 王淑麗, 等. 骨性關節炎患者膝關節軟骨損傷的關節鏡與 MRI 診斷分級研究. 中國矯形外科雜志, 2017, 25(1): 29-32.
11.	錢俊, 芮永軍, 張全榮, 等. Wassel Ⅰ、Ⅱ型復拇指畸形的手術治療. 中華手外科雜志, 2015, 31(4): 249-251.
12.	高偉陽, 丁健, 周宗偉. 先天性多拇畸形的研究進展. 中國修復重建外科雜志, 2018, 32(7): 827-831.
13.	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.
14.	南國新, 覃佳強, 王忠良, 等. 兒童WasselⅡ型復拇畸形術后繼發性畸形的原因分析. 中華小兒外科雜志, 2011, 32(6): 444-447.
15.	南國新, 蔡文全, 宿玉璽, 等. 非典型WasselⅥ型復拇畸形的手術治療. 中華小兒外科雜志, 2014, 35(6): 462-465.
16.	Wall LB, Goldfarb CA. Reconstruction for type Ⅳ radial polydactyly. J Hand Surg (Am), 2015, 40(9): 1873-1876.
17.	南國新, 覃佳強, 劉國棟, 等. Wassel Ⅳ-D型復拇畸形術后繼發性畸形原因分析. 中華小兒外科雜志, 2012, 33(7): 555-557.

1. Al-Aithan B, Al-Blaihed L, Mahmoud S, et al. Thumb polydactyly with symphalangism. J Hand Surg (Br), 2005, 30(4): 346-349.
2. 高偉陽, 王安遠, 丁健, 等. 末節先天復拇畸形的分型和術式選擇. 中華整形外科雜志, 2014, 30(5): 330-335.
3. Dijkman RR, van Nieuwenhoven CA, Selles RW, et al. Comparison of functional outcome scores in radial polydactyly. J Bone Joint Surg (Am), 2014, 96(6): 463-470.
4. Wassel HD. The results of surgery for polydactyly of the thumb. A review. Clin Orthop Relat Res, 1969, 64: 175-193.
5. Zuidam JM, Selles RW, Ananta M, et al. A classification system of radial polydactyly: inclusion of triphalangeal thumb and triplication. J Hand Surg (Am), 2008, 33(3): 373-377.
6. Takagi R, Kawabata H, Matsui Y. Thumb polydactyly with symphalangism in young children. J Hand Surg (Eur Vol), 2009, 34(6): 800-804.
7. 鐘文耀, 田文. 橈側多指畸形的影像學分型. 中國骨與關節雜志, 2017, 6(4): 301-304.
8. 陳時益, 高偉陽, 李俊杰, 等. MRI與關節鏡在診斷三角纖維軟骨復合體損傷中的差異及原因分析. 中華手外科雜志, 2015, 31(1): 34-37.
9. 黃碩, 谷文光, 李朋, 等. 前交叉韌帶損傷后膝關節半月板和軟骨的MRI定量分析研究進展. 中國矯形外科雜志, 2015, 23(14): 1291-1294.
10. 李顯, 趙力, 王淑麗, 等. 骨性關節炎患者膝關節軟骨損傷的關節鏡與 MRI 診斷分級研究. 中國矯形外科雜志, 2017, 25(1): 29-32.
11. 錢俊, 芮永軍, 張全榮, 等. Wassel Ⅰ、Ⅱ型復拇指畸形的手術治療. 中華手外科雜志, 2015, 31(4): 249-251.
12. 高偉陽, 丁健, 周宗偉. 先天性多拇畸形的研究進展. 中國修復重建外科雜志, 2018, 32(7): 827-831.
13. 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.
14. 南國新, 覃佳強, 王忠良, 等. 兒童WasselⅡ型復拇畸形術后繼發性畸形的原因分析. 中華小兒外科雜志, 2011, 32(6): 444-447.
15. 南國新, 蔡文全, 宿玉璽, 等. 非典型WasselⅥ型復拇畸形的手術治療. 中華小兒外科雜志, 2014, 35(6): 462-465.
16. Wall LB, Goldfarb CA. Reconstruction for type Ⅳ radial polydactyly. J Hand Surg (Am), 2015, 40(9): 1873-1876.
17. 南國新, 覃佳強, 劉國棟, 等. Wassel Ⅳ-D型復拇畸形術后繼發性畸形原因分析. 中華小兒外科雜志, 2012, 33(7): 555-557.

Chinese Journal of Reparative and Reconstructive Surgery

Diagnosis and treatment of thumb polydactyly with symphalangism in children

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