Feng Wenyu, Jiang Kun, Liu Dong, Fu Guoyong, Zheng Bufeng, Zhang Xu
Department of Pediatric Surgery, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Department of Orthopeadics, Binzhou Medical University Hospital, Binzhou, Shandong, China.
Acta Orthop Traumatol Turc. 2023 Mar;57(2):61-66. doi: 10.5152/j.aott.2023.22144.
This study aimed to introduce a minimally invasive technique in correcting residual zigzag deformities after early treatment of thumb duplication followed by fixation with a cemented frame.
Nineteen patients (14 males, 5 females; mean age, 12 years; age range, 8-14 years) with residual zigzag thumb deformities were treated with the minimally invasive technique from 2017 to 2019. The function and cosmesis of the thumbs were assessed using the Japanese Society for Surgery of the Hand.
The mean period between the first and the second operations was 35 months (range, 12-84 months). There were Wassel types III (n=4), IV (n=13), and V (n=2) residual zigzag thumb deformities. Preoperatively, the mean alignment deformities of the interphalangeal and metacarpophalangeal joints were 23° (12-42°) and 18° (11-33°), respectively. The mean function and cosmesis of the thumbs were 12 points (range, 8-14 points). There were 1 fair and 18 poor scores. At the final follow-up (mean, 28 months; range, 24-33 months), the mean alignment deformities of the interphalangeal and metacarpophalangeal joints were 1° (0-4°) and 18° (0-4°), respectively. The mean function and cosmesis of the thumbs were 18 points (range, 16-20 points). There were 5 excellent results, 13 good results, and 1 fair result.
Residual zigzag thumb deformities can be successfully corrected with the minimally invasive technique, resulting in good functional and cosmetic outcomes. The technique can be used as an alternative in selected cases.
Level IV, Therapeutic Study.
本研究旨在介绍一种微创技术，用于矫正拇指重复畸形早期治疗后残留的锯齿状畸形，并用骨水泥框架进行固定。
2017年至2019年，采用微创技术治疗19例（男14例，女5例；平均年龄12岁；年龄范围8 - 14岁）残留锯齿状拇指畸形患者。使用日本手部外科学会的标准评估拇指的功能和外观。
首次手术与第二次手术的平均间隔时间为35个月（范围12 - 84个月）。存在Wassel III型（n = 4）、IV型（n = 13）和V型（n = 2）残留锯齿状拇指畸形。术前，指间关节和掌指关节的平均对线畸形分别为23°（12 - 42°）和18°（11 - 33°）。拇指的平均功能和外观评分为12分（范围8 - 14分）。评分1例为良，18例为差。在末次随访时（平均28个月；范围24 - 33个月），指间关节和掌指关节的平均对线畸形分别为1°（0 - 4°）和18°（0 - 4°）。拇指的平均功能和外观评分为18分（范围16 - 20分）。结果为优5例，良13例，良1例。
微创技术可成功矫正残留的锯齿状拇指畸形，获得良好的功能和外观效果。该技术可作为特定病例的一种选择。
IV级，治疗性研究。
