Kim Justine S, Fowler John R, Davit Alexander J
Department of Plastic Surgery, University of Pittsburgh Medical Center, 3550 Terrace Street, 664 Scaife Hall, Pittsburgh, PA 15261, USA.
JPRAS Open. 2022 Feb 9;32:61-71. doi: 10.1016/j.jpra.2022.01.006. eCollection 2022 Jun.
Polydactyly is characterized by the manifestation of supernumerary digits in the hands and feet. It can be isolated or associated with a genetic syndrome. Based on the location of duplication, it is categorized as preaxial, postaxial, or central. The latter is a rare abnormality, comprising approximately 6% of cases. There is a paucity in the literature regarding this congenital anomaly and its overall management. Nonoperative treatment is generally unsuccessful in managing symptoms such as excessive width, abnormal digit alignment, and growth. Though surgical management addresses the individual patient's needs, general goals include preservation of digits with the greatest axial alignment, resection of symptomatic digits, alignment correction of the remaining great toe, stabilization of the soft tissues, and adequate soft tissue coverage. This study aims to delineate effective operative techniques for central foot polydactyly. Two patient cases are discussed, providing a framework for pre and postoperative care, complications, and outcomes. The techniques detailed offer a straightforward, efficacious, and safe method to reconstruct central foot polydactyly, returning form and function to the patient.
多指畸形的特征是手和脚上出现多余的手指。它可以是孤立的，也可以与遗传综合征相关。根据重复的位置，它可分为轴前型、轴后型或中央型。后者是一种罕见的异常，约占病例的6%。关于这种先天性畸形及其整体治疗，文献报道较少。非手术治疗通常无法有效缓解诸如宽度过大、手指排列异常和生长等症状。虽然手术治疗可满足个体患者的需求，但总体目标包括保留轴向排列最佳的手指、切除有症状的手指、矫正剩余大脚趾的排列、稳定软组织以及提供足够的软组织覆盖。本研究旨在阐述治疗中央型足多指畸形的有效手术技术。文中讨论了两个病例，为术前和术后护理、并发症及治疗结果提供了一个框架。所详述的技术为重建中央型足多指畸形提供了一种直接、有效且安全的方法，可使患者恢复外形和功能。
