Al-Qattan Noha M, Al-Qattan Mohammad M
From the Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
From the Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2017;39:88-92. doi: 10.1016/j.ijscr.2017.07.060. Epub 2017 Aug 8.
"On-top" and "side-to-side" plasties are techniques used for treating thumb duplications in which one thumb is adequate proximally and the other thumb contains a better pulp and nail distally. The detailed functional results of these techniques have not been reported in the literature. We report on two cases.
The first case had Wassel type VI duplication. The ulnar duplicate had a functioning interphalangeal joint and the radial duplicate had a functioning carpometacarpal joint. "On-top" plasty was done by putting the distal part of the ulnar duplicate on top of the proximal part of the radial duplicate. At 10 years after surgery, the outcome was excellent both cosmetically and functionally. In the second case (Wassel type VII with a zigzag deformity), the radial duplicate had a hypoplastic distal phalanx with no nail. The ulnar duplicate had a functioning interphalangeal joint and the radial duplicate had a functioning carpometacarpal joint. "Side-to-side" plasty was done by joining both thumbs side-to-side at the level of the proximal phalanx. At 3 years after surgery, the outcome we considered acceptable cosmetically and excellent functionally.
We could not find similar cases in the literature with detailed long-term postoperative results.
"On-top" and "side-to-side" plasties in the management of specific cases of thumb polydactyly obtain excellent functional results with excellent or acceptable cosmetic outcome.
“叠盖式”和“并排式”整形手术是用于治疗拇指多指畸形的技术，其中一个拇指近端发育正常，另一个拇指远端有更好的指腹和指甲。这些技术的详细功能结果在文献中尚未见报道。我们报告两例病例。
第一例为瓦塞尔VI型多指畸形。尺侧多指有一个可活动的指间关节，桡侧多指有一个可活动的腕掌关节。通过将尺侧多指的远端部分置于桡侧多指的近端部分之上进行“叠盖式”整形手术。术后10年，外观和功能效果均极佳。第二例（瓦塞尔VII型伴锯齿状畸形），桡侧多指远端指骨发育不全且无指甲。尺侧多指有一个可活动的指间关节，桡侧多指有一个可活动的腕掌关节。通过在近端指骨水平将两个拇指并排连接进行“并排式”整形手术。术后3年，我们认为外观可接受，功能极佳。
我们在文献中未找到有详细术后长期结果的类似病例。
在特定的拇指多指畸形病例中，“叠盖式”和“并排式”整形手术可获得极佳的功能结果以及极佳或可接受的外观效果。
