He Bo, Nan Guoxin
Department of Orthopaedics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Chongqing Key Laboratory of Pediatrics, Chongqing, China.
J Hand Surg Eur Vol. 2023 Apr;48(4):341-345. doi: 10.1177/17531934221133509. Epub 2023 Feb 6.
We studied the pathological anatomical structures of atypical Wassel Type VI thumb duplication to provide a theoretical basis for surgical treatment. Forty-seven patients with atypical Wassel Type VI thumb duplication were treated. We found that some of cases had an ulnar thumb without an extensor tendon, or without a flexor tendon, or without both. All the ulnar metacarpal bones were abnormal to variable degrees. On-top-plasty is currently the best procedure for the treatment of this type of anomaly. Flexor tendon reconstruction is an important factor in functional reconstruction of the thumb, and keeping the pulley and sheath intact is a key step in flexor tendon reconstruction. Placing the on-top-plasty level at the distal end of the metacarpal or at the proximal phalanx depends on the presence of the flexor tendon. According to the condition of the flexor tendon, the atypical Wassel Type IV duplication can be divided into two types: the absent type and the intact type. VI.
我们研究了非典型瓦塞尔VI型拇指重复畸形的病理解剖结构，为手术治疗提供理论依据。对47例非典型瓦塞尔VI型拇指重复畸形患者进行了治疗。我们发现部分病例的尺侧拇指无伸肌腱，或无屈肌腱，或两者均无。所有尺侧掌骨均有不同程度的异常。目前，顶置成形术是治疗此类畸形的最佳手术方法。屈肌腱重建是拇指功能重建的重要因素，保持滑车和腱鞘完整是屈肌腱重建的关键步骤。顶置成形术的水平置于掌骨远端还是近端指骨取决于屈肌腱的情况。根据屈肌腱的情况，非典型瓦塞尔IV型重复畸形可分为两型：缺如型和完整型。VI。
