Tang Haipeng, Sun Guangfeng, Qi Jianping, Nie Kaiyu, Jin Wenhu, Li Shujun, Wei Zairong, Wang Dali
Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi Guizhou, 563000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Sep 8;30(9):1127-1129. doi: 10.7507/1002-1892.20160229.
To study the effectiveness of surgical treatment of congenital type V thumb syndactyly.
Between March 2010 and May 2015, 12 cases of congenital type V thumb syndactyly were treated. There were 7 males and 5 females, aged from 1 to 25 years (mean, 8 years). The right thumb was involved in 8 cases, and the left thumb in 4 cases. There were 2 cases of radial type, and 10 cases of ulnar type. The basement of polydactylism was far away from the carpometacarpal joint in 7 cases, and was close to the carpometacarpal joint in 5 cases (slight ulnar deviation in 1 case). X-ray films showed that the main first thumb metacarpal bone and trapezium fitted well, and 2 cases had the first metacarpal bone deformity. Preoperative individualized treatment plan was made, and polydactylism was excised by the "S" or "Z" incision and simultaneous reconstruction of thenar muscle insertions or adductor muscle insertions was performed; if necessary, wedge osteotomy was used for correction.
All incisions healed by first intention with no complication. All cases were followed up 6 to 24 months (mean, 12 months). The thumb appearance, flexion and extension, the function of opposition, abduction function were improved significantly in 11 cases with no scar contracture deformity, small first web space, and deviation deformity. One case had slightly narrow first web space. According to hand function criterion, the results were excellent in 10 cases, good in 1 case, poor in 1 case; excellent and good rate was 91.7%.
Based on the condition of the type V thumb syndactyly, the individualized treatment plan is made, which can better restore the shape and function of the thumb.
研究先天性Ⅴ型拇指并指手术治疗的有效性。
2010年3月至2015年5月，对12例先天性Ⅴ型拇指并指患者进行治疗。其中男性7例，女性5例，年龄1至25岁（平均8岁）。右侧拇指受累8例，左侧拇指受累4例。桡侧型2例，尺侧型10例。7例多指基底远离腕掌关节，5例靠近腕掌关节（其中1例有轻度尺偏）。X线片显示，主要的第一拇指掌骨与大多角骨匹配良好，2例有第一掌骨畸形。制定术前个体化治疗方案，采用“S”形或“Z”形切口切除多指，同时重建鱼际肌止点或内收肌止点；必要时采用楔形截骨矫正。
所有切口均一期愈合，无并发症。所有病例均随访6至24个月（平均12个月）。11例拇指外观、屈伸、对掌功能、外展功能明显改善，无瘢痕挛缩畸形、第一蹼间隙小及偏斜畸形。1例第一蹼间隙略窄。按手功能标准评定，优10例，良1例，差1例；优良率为91.7%。
根据Ⅴ型拇指并指情况制定个体化治疗方案，可较好恢复拇指外形及功能。
