Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, China; Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2 road 136#, Chongqing 400014, China.
Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Yuzhong District Zhongshan 2 road 136#, Chongqing 400014, China.
J Plast Reconstr Aesthet Surg. 2022 Aug;75(8):2644-2649. doi: 10.1016/j.bjps.2022.02.036. Epub 2022 Feb 26.
The Bilhaut-Cloquet technique is the preferred surgical method for thumb polydactyly with symmetrical caliber and osseous components. However, the traditional Bilhaut-Cloquet technique has many esthetic and functional complications. In this study, we aimed to investigate an effective modified Bilhaut-Cloquet procedure for Wassel type IV thumb duplication.
The dorsal scar of the thumb was hidden on the ulnar side of the thumb through the flap design. The nail bed was sutured flat by combining the phalangeal bone and nail bed on different planes. The sensory function of the thumb was restored by keeping the ulnar skin of the thumb intact.
Our modified Bilhaut-Cloquet procedure did not reduce the mobility of the joints. All patients had relatively rounded fingernails, and no seagull deformity was present. The ulnar side of the palm skin of the thumb remained intact with no scars, maximizing the preservation of the sensory function of the thumb. All the operated children and their parents were satisfied with the esthetic result.
We hid the surgical scar by improving the surgical method and reducing the thumb seagull nail deformity, and the influencing of the finger sensation caused by the scar on the finger abdomen. The procedure improved not only the appearance of the reconstructed thumbs but also the sensory function of the thumbs.
对于对称性指骨和骨成分的拇指多指畸形，Bilhaut-Cloquet 技术是首选的手术方法。然而，传统的 Bilhaut-Cloquet 技术有许多美学和功能并发症。在本研究中，我们旨在探讨一种有效的改良 Bilhaut-Cloquet 术式，用于 Wassel Ⅳ型拇指复拇指畸形。
拇指背侧瘢痕通过皮瓣设计隐藏在拇指尺侧。通过在不同平面上结合指骨和甲床来使甲床平整缝合。通过保持拇指尺侧皮肤完整来恢复拇指的感觉功能。
我们改良的 Bilhaut-Cloquet 手术不会降低关节的活动度。所有患者的指甲均相对圆润，无海鸥畸形。拇指掌侧尺侧皮肤完整，无瘢痕，最大限度地保留拇指感觉功能。所有手术患儿及其家长对手术效果均满意。
我们通过改进手术方法和减少拇指海鸥甲畸形和瘢痕对指腹的手指感觉的影响，隐藏了手术瘢痕。该手术不仅改善了重建拇指的外观，而且还改善了拇指的感觉功能。
