Zuidam J Michiel, Selles Ruud W, Ananta Michael, Runia Jetteke, Hovius Steven E R
Department of Plastic and Reconstructive Surgery, Erasmus Medical Centre Rotterdam, The Netherlands.
J Hand Surg Am. 2008 Mar;33(3):373-7. doi: 10.1016/j.jhsa.2007.12.012.
Radial polydactyly is a congenital anomaly with a wide range of manifestations. Current classifications do not have the capacity to classify all different types of radial polydactyly when combined with triphalangeal components. The objective of this study was to test an adjusted classification and nomenclature that allows classification of triphalangeal components and triplication in radial polydactyly.
Patients from 1993 to 2006 with radial polydactyly (N = 104), a total of 121 affected hands, were identified from the hospital database. All x-rays were carefully examined and classified according to the existing classifications for radial polydactyly and a modified classification. In the modified nomenclature, Wassel's level of duplication is preserved. Type VII and VIII are assigned for partial or complete duplication of the carpal bones according to Buck-Gramcko. Triplication and triphalangeal components can be assigned to each type of radial polydactyly by suffixes. Symphalangism, deviation, and hypoplasia can also be classified. Triplication on different levels of the thumb is classified by determining and including the different types of the original Wassel classification.
Eighteen thumbs could not be classified according to existing classifications for radial polydactyly with triphalangeal components or triplication. Using the proposed classification, all patients could be classified.
We propose a modified classification that is a practical and utilitarian scheme for nomenclature of radial polydactyly and that may assist comparison of treatment outcomes and individual cases.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
桡侧多指畸形是一种具有广泛临床表现的先天性异常。当前的分类方法在结合三节指骨成分时，无法对所有不同类型的桡侧多指畸形进行分类。本研究的目的是测试一种经过调整的分类和命名方法，该方法能够对桡侧多指畸形中的三节指骨成分和多指重复进行分类。
从医院数据库中识别出1993年至2006年患有桡侧多指畸形的患者（N = 104），共121只患手。所有X线片均根据现有的桡侧多指畸形分类方法和一种改良分类方法进行仔细检查和分类。在改良命名法中，保留了瓦塞尔（Wassel）的多指重复分级。根据巴克-格拉姆科（Buck-Gramcko）的方法，将腕骨部分或完全重复的情况归为VII型和VIII型。通过后缀可将多指重复和三节指骨成分分配到每种类型的桡侧多指畸形中。关节融合、偏斜和发育不全也可进行分类。通过确定并纳入原始瓦塞尔分类的不同类型，对拇指不同水平的多指重复进行分类。
根据现有的伴有三节指骨成分或多指重复的桡侧多指畸形分类方法，有18个拇指无法分类。使用所提出的分类方法，所有患者均可分类。
我们提出一种改良分类方法，它是一种实用且功利的桡侧多指畸形命名方案，可能有助于比较治疗结果和个体病例。
研究类型/证据水平：诊断性研究II级。
