Maillet Marie, Fron Damien, Martinot-Duquennoy Véronique, Herbaux Bernard
Clinique d'Orthopédie et de Chirurgie de l'Enfant, Hôpital Jeanne de Flandre, 3 Avenue Eugène Avinée, 59037, Lille Cedex, France,
J Child Orthop. 2007 Jul;1(2):135-41. doi: 10.1007/s11832-007-0019-3. Epub 2007 May 5.
Purpose This study reports the results of surgical treatment of thumb duplication in the Clinique d'Orthopédie et de Chirurgie de l'Enfant de l'Hôpital Jeanne de Flandre in Lille (France). Methods Thirty patients (33 thumbs) operated on between 1995 and 2003 are clinically reviewed. Results The mean postoperative follow-up was 3 years and 11 months. According to Wassel's classification, the series included 12 type II duplications, two type III, 14 type IV, two type V, one type VI and two type VII. The surgical approaches consisted of simple resection of the most hypoplastic thumb (16 thumbs), the Bilhaut-Cloquet procedure (ten thumbs) and resection associated with reconstructive surgery (seven thumbs). The Bilhaut-Cloquet procedure was used in three cases for treatment of type IV duplication On the basis of the Tada scoring system, we obtained 24 good results, eight fair results and one poor result. Conclusion Based on our results, we recommend that the Bilhaut-Cloquet procedure be used not only for the treatment of type II duplication when the thumbs are both hypoplastic and symmetric but also for type IV duplication with the same clinical parameters. For the other types of duplications, we consider that resection of the most hypoplastic thumb associated with reconstructive surgery is the best surgical approach. For type VII duplication, ablation of the triphalangeal thumb remains the best option. We do not recommend osteotomy at the first surgery.
目的 本研究报告了法国里尔让娜·德·佛兰德斯医院儿童矫形与外科诊所对拇指重复畸形的手术治疗结果。方法 对1995年至2003年间接受手术的30例患者（33根拇指）进行临床回顾。结果 术后平均随访时间为3年11个月。根据瓦塞尔分类法，该系列包括12例II型重复畸形、2例III型、14例IV型、2例V型、1例VI型和2例VII型。手术方法包括单纯切除发育最差的拇指（16根拇指）、比尔奥-克洛凯手术（10根拇指）以及切除并进行重建手术（7根拇指）。比尔奥-克洛凯手术在3例IV型重复畸形的治疗中使用。基于多田评分系统，我们获得了24个良好结果、8个中等结果和1个差的结果。结论 根据我们的结果，我们建议比尔奥-克洛凯手术不仅用于治疗拇指均发育不良且对称的II型重复畸形，也用于具有相同临床参数的IV型重复畸形。对于其他类型的重复畸形，我们认为切除发育最差的拇指并进行重建手术是最佳手术方法。对于VII型重复畸形，切除三节指骨拇指仍是最佳选择。我们不建议在初次手术时进行截骨术。
