Recent progress in research of congenital polydactyly_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 GAO Weiyang , DING Jian , ZHOU Zongwei

Department of Hand and Plastic Surgery, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325027, P.R.China;

Corresponding author：

GAO Weiyang, Email: wygao1@163.com

Keywords：

Congenital polydactyly; classifcation; surgery treatment; Bihault-Cloquet procedure

DOI：

10.7507/1002-1892.201806091

Video：

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Surgery is still the main treatment for congenital polydactyly, and the aim of surgical reconstruction is to obtain a thumb with excellent function and appearance. A systematic assessment of polydactyly is required prior to surgery, including bone stress lines, joint deviation, joint activity and joint instability, size and development of finger and nail. Bone shape, joint incongruency, and abnormal tendon insertions must be corrected completely, in order to obtain good function and to avoide secondary surgery. Bilhault-Cloquet procedure can reconstruct the size of the finger and nails. Fine manipulation can improve the postoperative nail deformity, so that the reconstructed nail reaches a satisfactory aesthetic score.

Citation： GAO Weiyang, DING Jian, ZHOU Zongwei. Recent progress in research of congenital polydactyly. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(7): 827-831. doi: 10.7507/1002-1892.201806091 Copy

1.	Guo B, Lee SK, Paksima N. Polydactyly: a review. Bull Hosp Jt Dis (2013), 2013, 71(1): 17-23.
2.	Tada K, Yonenobu K, Tsuyuguchi Y, et al. Duplication of the thumb: A retrospective review of two hundred and thirty seven cases. J Bone Joint Surg (Am), 1983, 65(5): 584-598.
3.	Dobyns JH, Lipscomb PR, Cooney WP. Management of thumb duplication. Clin Orthop Relat Res, 1985, (195): 26-44.
4.	Ogino T, Ishii S, Takahata S, et al. Long-term results of surgical treatment of thumb polydactyly. J Hand Surg (Am), 1996, 21(3): 478-486.
5.	Faust KC, Kimbrough T, Oakes JE, et al. Polydactyly of the hand. Am J Orthop (Bell Mead NJ), 2015, 44(5): E127-E134.
6.	Zaleske DJ. Development of the upper limb. Hand Clin, 1985, 1(1): 383-390.
7.	周宗伟, 高伟阳. 先天性多指畸形分子遗传学研究现状. 国际遗传学杂志, 2016, 39(2): 112-116, 封3.
8.	Lettice LA, Heaney SJ, Purdie LA, et al. A long-range Shh enhancer regulates expression in the developing limb and fin and is associated with preaxial polydactyly. Hum Mol Genet, 2003, 12(14): 1725-1735.
9.	Anderson E, Peluso S, Lettice LA, et al. Human limb abnormalities caused by disruption of hedgehog signaling. Trends Genet, 2012, 28(8): 364-373.
10.	Koshiba-Takeuchi K, Takeuchi JK, Arruda EP, et al. Cooperative and antagonistic interactions between Sall4 and Tbx5 pattern the mouse limb and heart. Nat Genet, 2006, 38(2): 175-183.
11.	Buck-Gramcko D, Behrens P. Classification of polydactyly of the hand and foot. Handchir Mikrochir Plast Chir, 1989, 21(4): 195-204.
12.	Flatt AE. A test of a classification of congenital anomalies of the upper extremity. Surg Clin North Am, 1970, 50(2): 509-516.
13.	Stutz C, Mills J, Wheeler L, et al. Long-term outcomes following radial polydactyly reconstruction: level 4 evidence. J Hand Surg (Am), 2014, 39(8): 1549-1552.
14.	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.
15.	Dijkman RR, van Nieuwenhoven CA, Selles RW, et al. A multicenter comparative study of two classification systems for radial polydactyly. Plast Reconstr Surg, 2014, 134(5): 991-1001.
16.	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.
17.	Saito S, Ueda M, Takahashi N, et al. Three-dimensional ultrasonography for visualization of muscular anomalies in type Ⅵand Ⅶ radial polydactyly. Skelet Radiol, 2016, 45(4): 541-547.
18.	高伟阳, Salman Fraooqi, 石炜, 等. 推移岛状复合组织瓣重建发育不良性复拇畸形指体. 中华整形外科杂志, 2016, 32(5): 321-327.
19.	于亚东, 洪光祥, 邵新中, 等. 特殊检查在复拇指畸形诊断中的价值. 中华手外科杂志, 2003, 19(1): 18-20.
20.	Maillet M, Fron D, Martinot-Duquennoy V, et al. Results after surgical treatment of thumb duplication: a retrospective review of 33 thumbs. J Child Orthop, 2007, 1(2): 135-141.
21.	Iwasawa M, Noguchi M, Mishima Y, et al. Long-term results of nail fusion plasty of the duplicated thumb. J Plast Reconstr Aesthetic Surg, 2008, 61(9): 1085-1089.
22.	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.
23.	高伟阳, 丁健, 王安远. 改良指甲、骨关节和切口成形技术的 Bilhaut-Cloquet 术治疗多拇畸形. 中华骨科杂志, 2016, 36(16): 1033-1043.
24.	Perez-Lopez LM, Gutierrez-de la lglesia D, Cabrera-Gonzalez M. Radial polydactyly. What’s new?. Curr Pediatr Rev, 2018. [Epub ahead of print].
25.	Hartrampf CR, Vasconez LO, Mathes S. Construction of one good thumb from both parts of a congenitally bifid thumb. Plast Reconstr Surg, 1974, 54(2): 148-152.
26.	Iba K, Wada T, Yamashita T. Atypical thumb polydactyly with duplicated metacarpal bone: a report of 2 cases. Ann Plast Surg, 2013, 70(1): 38-41.
27.	Pons-Riverola A, Camprubi-Garcia E, Barrera-Ochoa S, et al. On-Top-Plasty for atypical thumb duplication: a case report with 10 year follow-up. Hand (N Y), 2018. [Epub ahead of print].
28.	Hung NN. Bifid thumb type Ⅳ in children: transferring an epiphyseal segment of the proximal phalanx with insertion of the abductor pollicis brevis tendon. J Child Orthop, 2010, 4(6): 525-537.
29.	Engelhardt TO, Baur EM, Pedross F, et al. Supporting the collateral ligament complex in radial polydactyly type Wassel Ⅳ. J Plast Reconstr Aesthet Surg, 2013, 66(1): 104-112.
30.	He B, Nan G. Causes of secondary deformity after surgery to correct Wassel type Ⅳ-D thumb duplication. J Hand Surg (Eur Vol), 2016, 41(7): 739-744.
31.	de Almeida CEF. Analysis of surgical results and of residual postoperative deformities in preaxial polydactyly of the hand. J Plast Reconstr Aesthet Surg, 2017, 70(10): 1420-1432.
32.	Tonkin MA, Bulstrode NW. The Bilhaut-Cloquet procedure for Wassel types Ⅲ, Ⅳ and Ⅶ thumb duplication. J Hand Surg (Eur Vol), 2007, 32(6): 684-693.
33.	Marks TW, Bayne LG. Polydactyly of the thumb: abnormal anatomy and treatment. J Hand Surg (Am), 1978, 3(2): 107-116.
34.	Cheng JC, Chan KM, Ma GF, et al. Polydactyly of the thumb: a surgical plan based on ninety-five cases. J Hand Surg (Am), 1984, 9(2): 155-164.
35.	Wang AY, Gao WY, Wu LM, et al. Nail fusion plasty: nail cosmetic results and assessment criteria of nail reconstruction. Ann Plast Surg, 2015, 75(3): 290-294.
36.	Wang L, Tao X, Gao W, et al. Postoperative growth in radial polydactyly: a clinical study. J Hand Surg (Am), 2016, 41(9): e273-e278.
37.	Dautel G, Perrin P. Use of an axial flap to increase the girth of Wassel Ⅳ thumb reconstructions. J Hand Surg (Am), 2015, 40(7): 1327-1332.
38.	Samson P, Salazard B, Magalon G. The " Bilhaut-Cloquet” technique for treatment of thumb duplication. Handchir Mikrochir Plast Chir, 2004, 36(2-3): 141-145.
39.	Baek GH, Gong HS, Chung MS, et al. Modified Bilhaut-Cloquet procedure for Wassel type-Ⅱ and Ⅲ polydactyly of the thumb. J Bone Joint Surg (Am), 2007, 89(3): 534-541.

1. Guo B, Lee SK, Paksima N. Polydactyly: a review. Bull Hosp Jt Dis (2013), 2013, 71(1): 17-23.
2. Tada K, Yonenobu K, Tsuyuguchi Y, et al. Duplication of the thumb: A retrospective review of two hundred and thirty seven cases. J Bone Joint Surg (Am), 1983, 65(5): 584-598.
3. Dobyns JH, Lipscomb PR, Cooney WP. Management of thumb duplication. Clin Orthop Relat Res, 1985, (195): 26-44.
4. Ogino T, Ishii S, Takahata S, et al. Long-term results of surgical treatment of thumb polydactyly. J Hand Surg (Am), 1996, 21(3): 478-486.
5. Faust KC, Kimbrough T, Oakes JE, et al. Polydactyly of the hand. Am J Orthop (Bell Mead NJ), 2015, 44(5): E127-E134.
6. Zaleske DJ. Development of the upper limb. Hand Clin, 1985, 1(1): 383-390.
7. 周宗伟, 高伟阳. 先天性多指畸形分子遗传学研究现状. 国际遗传学杂志, 2016, 39(2): 112-116, 封3.
8. Lettice LA, Heaney SJ, Purdie LA, et al. A long-range Shh enhancer regulates expression in the developing limb and fin and is associated with preaxial polydactyly. Hum Mol Genet, 2003, 12(14): 1725-1735.
9. Anderson E, Peluso S, Lettice LA, et al. Human limb abnormalities caused by disruption of hedgehog signaling. Trends Genet, 2012, 28(8): 364-373.
10. Koshiba-Takeuchi K, Takeuchi JK, Arruda EP, et al. Cooperative and antagonistic interactions between Sall4 and Tbx5 pattern the mouse limb and heart. Nat Genet, 2006, 38(2): 175-183.
11. Buck-Gramcko D, Behrens P. Classification of polydactyly of the hand and foot. Handchir Mikrochir Plast Chir, 1989, 21(4): 195-204.
12. Flatt AE. A test of a classification of congenital anomalies of the upper extremity. Surg Clin North Am, 1970, 50(2): 509-516.
13. Stutz C, Mills J, Wheeler L, et al. Long-term outcomes following radial polydactyly reconstruction: level 4 evidence. J Hand Surg (Am), 2014, 39(8): 1549-1552.
14. 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.
15. Dijkman RR, van Nieuwenhoven CA, Selles RW, et al. A multicenter comparative study of two classification systems for radial polydactyly. Plast Reconstr Surg, 2014, 134(5): 991-1001.
16. 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.
17. Saito S, Ueda M, Takahashi N, et al. Three-dimensional ultrasonography for visualization of muscular anomalies in type Ⅵand Ⅶ radial polydactyly. Skelet Radiol, 2016, 45(4): 541-547.
18. 高伟阳, Salman Fraooqi, 石炜, 等. 推移岛状复合组织瓣重建发育不良性复拇畸形指体. 中华整形外科杂志, 2016, 32(5): 321-327.
19. 于亚东, 洪光祥, 邵新中, 等. 特殊检查在复拇指畸形诊断中的价值. 中华手外科杂志, 2003, 19(1): 18-20.
20. Maillet M, Fron D, Martinot-Duquennoy V, et al. Results after surgical treatment of thumb duplication: a retrospective review of 33 thumbs. J Child Orthop, 2007, 1(2): 135-141.
21. Iwasawa M, Noguchi M, Mishima Y, et al. Long-term results of nail fusion plasty of the duplicated thumb. J Plast Reconstr Aesthetic Surg, 2008, 61(9): 1085-1089.
22. 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.
23. 高伟阳, 丁健, 王安远. 改良指甲、骨关节和切口成形技术的 Bilhaut-Cloquet 术治疗多拇畸形. 中华骨科杂志, 2016, 36(16): 1033-1043.
24. Perez-Lopez LM, Gutierrez-de la lglesia D, Cabrera-Gonzalez M. Radial polydactyly. What’s new?. Curr Pediatr Rev, 2018. [Epub ahead of print].
25. Hartrampf CR, Vasconez LO, Mathes S. Construction of one good thumb from both parts of a congenitally bifid thumb. Plast Reconstr Surg, 1974, 54(2): 148-152.
26. Iba K, Wada T, Yamashita T. Atypical thumb polydactyly with duplicated metacarpal bone: a report of 2 cases. Ann Plast Surg, 2013, 70(1): 38-41.
27. Pons-Riverola A, Camprubi-Garcia E, Barrera-Ochoa S, et al. On-Top-Plasty for atypical thumb duplication: a case report with 10 year follow-up. Hand (N Y), 2018. [Epub ahead of print].
28. Hung NN. Bifid thumb type Ⅳ in children: transferring an epiphyseal segment of the proximal phalanx with insertion of the abductor pollicis brevis tendon. J Child Orthop, 2010, 4(6): 525-537.
29. Engelhardt TO, Baur EM, Pedross F, et al. Supporting the collateral ligament complex in radial polydactyly type Wassel Ⅳ. J Plast Reconstr Aesthet Surg, 2013, 66(1): 104-112.
30. He B, Nan G. Causes of secondary deformity after surgery to correct Wassel type Ⅳ-D thumb duplication. J Hand Surg (Eur Vol), 2016, 41(7): 739-744.
31. de Almeida CEF. Analysis of surgical results and of residual postoperative deformities in preaxial polydactyly of the hand. J Plast Reconstr Aesthet Surg, 2017, 70(10): 1420-1432.
32. Tonkin MA, Bulstrode NW. The Bilhaut-Cloquet procedure for Wassel types Ⅲ, Ⅳ and Ⅶ thumb duplication. J Hand Surg (Eur Vol), 2007, 32(6): 684-693.
33. Marks TW, Bayne LG. Polydactyly of the thumb: abnormal anatomy and treatment. J Hand Surg (Am), 1978, 3(2): 107-116.
34. Cheng JC, Chan KM, Ma GF, et al. Polydactyly of the thumb: a surgical plan based on ninety-five cases. J Hand Surg (Am), 1984, 9(2): 155-164.
35. Wang AY, Gao WY, Wu LM, et al. Nail fusion plasty: nail cosmetic results and assessment criteria of nail reconstruction. Ann Plast Surg, 2015, 75(3): 290-294.
36. Wang L, Tao X, Gao W, et al. Postoperative growth in radial polydactyly: a clinical study. J Hand Surg (Am), 2016, 41(9): e273-e278.
37. Dautel G, Perrin P. Use of an axial flap to increase the girth of Wassel Ⅳ thumb reconstructions. J Hand Surg (Am), 2015, 40(7): 1327-1332.
38. Samson P, Salazard B, Magalon G. The " Bilhaut-Cloquet” technique for treatment of thumb duplication. Handchir Mikrochir Plast Chir, 2004, 36(2-3): 141-145.
39. Baek GH, Gong HS, Chung MS, et al. Modified Bilhaut-Cloquet procedure for Wassel type-Ⅱ and Ⅲ polydactyly of the thumb. J Bone Joint Surg (Am), 2007, 89(3): 534-541.

Chinese Journal of Reparative and Reconstructive Surgery

Recent progress in research of congenital polydactyly

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