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

Video：

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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.	高伟阳, 王安远, 丁健, 等. 末节先天复拇畸形的分型和术式选择. 中华整形外科杂志, 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.	钟文耀, 田文. 桡侧多指畸形的影像学分型. 中国骨与关节杂志, 2017, 6(4): 301-304.
8.	陈时益, 高伟阳, 李俊杰, 等. MRI与关节镜在诊断三角纤维软骨复合体损伤中的差异及原因分析. 中华手外科杂志, 2015, 31(1): 34-37.
9.	黄硕, 谷文光, 李朋, 等. 前交叉韧带损伤后膝关节半月板和软骨的MRI定量分析研究进展. 中国矫形外科杂志, 2015, 23(14): 1291-1294.
10.	李显, 赵力, 王淑丽, 等. 骨性关节炎患者膝关节软骨损伤的关节镜与 MRI 诊断分级研究. 中国矫形外科杂志, 2017, 25(1): 29-32.
11.	钱俊, 芮永军, 张全荣, 等. Wassel Ⅰ、Ⅱ型复拇指畸形的手术治疗. 中华手外科杂志, 2015, 31(4): 249-251.
12.	高伟阳, 丁健, 周宗伟. 先天性多拇畸形的研究进展. 中国修复重建外科杂志, 2018, 32(7): 827-831.
13.	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.
14.	南国新, 覃佳强, 王忠良, 等. 儿童WasselⅡ型复拇畸形术后继发性畸形的原因分析. 中华小儿外科杂志, 2011, 32(6): 444-447.
15.	南国新, 蔡文全, 宿玉玺, 等. 非典型WasselⅥ型复拇畸形的手术治疗. 中华小儿外科杂志, 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.	南国新, 覃佳强, 刘国栋, 等. Wassel Ⅳ-D型复拇畸形术后继发性畸形原因分析. 中华小儿外科杂志, 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. 高伟阳, 王安远, 丁健, 等. 末节先天复拇畸形的分型和术式选择. 中华整形外科杂志, 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. 钟文耀, 田文. 桡侧多指畸形的影像学分型. 中国骨与关节杂志, 2017, 6(4): 301-304.
8. 陈时益, 高伟阳, 李俊杰, 等. MRI与关节镜在诊断三角纤维软骨复合体损伤中的差异及原因分析. 中华手外科杂志, 2015, 31(1): 34-37.
9. 黄硕, 谷文光, 李朋, 等. 前交叉韧带损伤后膝关节半月板和软骨的MRI定量分析研究进展. 中国矫形外科杂志, 2015, 23(14): 1291-1294.
10. 李显, 赵力, 王淑丽, 等. 骨性关节炎患者膝关节软骨损伤的关节镜与 MRI 诊断分级研究. 中国矫形外科杂志, 2017, 25(1): 29-32.
11. 钱俊, 芮永军, 张全荣, 等. Wassel Ⅰ、Ⅱ型复拇指畸形的手术治疗. 中华手外科杂志, 2015, 31(4): 249-251.
12. 高伟阳, 丁健, 周宗伟. 先天性多拇畸形的研究进展. 中国修复重建外科杂志, 2018, 32(7): 827-831.
13. 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.
14. 南国新, 覃佳强, 王忠良, 等. 儿童WasselⅡ型复拇畸形术后继发性畸形的原因分析. 中华小儿外科杂志, 2011, 32(6): 444-447.
15. 南国新, 蔡文全, 宿玉玺, 等. 非典型WasselⅥ型复拇畸形的手术治疗. 中华小儿外科杂志, 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. 南国新, 覃佳强, 刘国栋, 等. Wassel Ⅳ-D型复拇畸形术后继发性畸形原因分析. 中华小儿外科杂志, 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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