Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, Korea.
Foot Ankle Int. 2013 Apr;34(4):563-7. doi: 10.1177/1071100713477608. Epub 2013 Feb 28.
Polydactyly of the fifth toe is the most common congenital malformation of the forefoot, and no consensus has been reached as to which toe component should be excised or by which surgical technique. The purpose of this study was to evaluate the results of the operative treatment of postaxial polydactyly and to offer treatment guidelines.
We retrospectively reviewed the details of 27 patients with postaxial polydactyly (36 feet) treated from September 2004 to March 2010. To select the dominant toe of postaxial polydactyly, we evaluated the morphological and radiological configurations. To excise the medial toe, we treated the polydactyly by dorsal rectangular flap and a full-thickness inguinal skin graft. To excise the lateral toe, we treated the polydactyly by racket-shape incision. Patient satisfaction indices were evaluated on the basis of responses to the PSQ-10 patient satisfaction questionnaire and clinical outcomes.
Overall surgical outcomes were satisfactory with the exception of 2 cases of skin graft problems. Eighteen of the 36 reconstructed toes were smaller than the normal toes, but valgus deformity was observed in only 3 cases.
The described medial toe excision technique and the devised toe selection algorithm were able to satisfy functional and cosmetic requirements.
第五趾的多趾畸形是最常见的前足先天性畸形，但对于应该切除哪个趾骨成分以及采用哪种手术技术，尚未达成共识。本研究旨在评估轴后多趾畸形的手术治疗结果，并提供治疗指南。
我们回顾性分析了 2004 年 9 月至 2010 年 3 月期间收治的 27 例（36 足）轴后多趾畸形患者的详细资料。为了选择轴后多趾的优势趾，我们评估了其形态和影像学特征。对于内侧趾骨的切除，我们采用背侧矩形皮瓣和全厚腹股沟皮片进行治疗。对于外侧趾骨的切除，我们采用球拍状切口进行治疗。根据 PSQ-10 患者满意度问卷和临床结果评估患者满意度指数。
除 2 例皮片问题外，总体手术结果令人满意。36 个重建足趾中有 18 个小于正常足趾，但仅 3 例出现外翻畸形。
所描述的内侧趾骨切除技术和设计的趾骨选择算法能够满足功能和美容要求。
