Du Zijing, Cui Yan, Jiang Hao, Han Dong
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Hand Surgery, Jinshan Hospital of Fudan University, Shanghai, China.
Front Pediatr. 2023 Jul 7;11:1192168. doi: 10.3389/fped.2023.1192168. eCollection 2023.
Wassel type IV-D thumb duplication is the most complex form and anatomic reconstruction is difficult. The aim of this study was to create an aesthetically satisfactory anatomical reconstruction for Wassel type IV-D radial polydactyly thumbs using the modified Bilhaut-Cloquet procedure. Surgery was performed on 24 thumbs with Wassel type IV-D radial polydactyly. To align the joint surfaces, the proximal phalanxes were unequally joined, primarily on the ulnar, and the distal phalanx was either symmetrically joined or unequally joined via curvature osteotomy. The patients were followed up for 12-91 months. The interphalangeal joint remained stable in all cases. The average functional score was 13.5 points (maximum 14 points). The overall average cosmetic score was 3.3 (maximum 4 points). Our modification of the Bihaut-Cloquet procedure produced good functional results for patients with Wassel type IV-D radial polydactyly. This method is used to correct the alignment and to stabilize the interphalangeal joint in both hypoplastic thumbs.
瓦塞尔IV - D型拇指重复畸形是最复杂的类型，解剖重建困难。本研究的目的是使用改良的比洛特 - 克洛凯手术为瓦塞尔IV - D型桡侧多指拇指创建一个美学上令人满意的解剖重建。对24例瓦塞尔IV - D型桡侧多指拇指进行了手术。为了对齐关节面，近端指骨主要在尺侧进行不等长连接，远端指骨通过弯曲截骨术进行对称连接或不等长连接。对患者进行了12 - 91个月的随访。所有病例指间关节均保持稳定。平均功能评分为13.5分（满分14分）。总体平均美容评分为3.3分（满分4分）。我们对比洛特 - 克洛凯手术的改良为瓦塞尔IV - D型桡侧多指拇指患者带来了良好的功能结果。该方法用于矫正两个发育不全拇指的对线并稳定指间关节。
