Ismiarto Yoyos Dias, Phandu Mirna, Handoko Hans Kristian, Prasetiyo Gregorius Thomas, Kamaris Fajri Rozi, Telaumbanua Tri Taufiqurachman
Division of Pediatrics Orthopaedic Surgery, Department of Orthopaedics and Traumatology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia.
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Int J Surg Case Rep. 2024 Sep;122:110064. doi: 10.1016/j.ijscr.2024.110064. Epub 2024 Jul 20.
Polydactyly is the most common congenital malformation in the limbs. However, it is rare for a patient to exhibit concomitant preaxial and postaxial polydactyly alongside syndactyly in both limbs, and there are limited recommendations for such conditions. This report presents a case of bilateral preaxial and postaxial polydactyly with syndactyly of the feet.
A 2-year-old girl was presented with an excess number of toes on both feet and an abnormal connection between the second and third toes. After a physical examination and plain radiography, the patient was diagnosed with bilateral preaxial and postaxial polydactyly with syndactyly. We performed a one-stage surgical correction consisting of ablation at the extra digit of bilateral great and little toes, followed by syndactyly release using z-plasty. The surgery was uneventful, and the parents were satisfied with the result.
A plain radiograph is necessary for pre-operative planning. We discarded the excess digits for cosmetics and soft and hard tissue for optimal function. It is necessary to preserve the soft tissues, remove the auxiliary digit, realign the digit, and restore the ligaments to preserve digit stability.
The complexity of this case required a meticulous surgical approach to address the structural abnormalities, restore functionality, and improve cosmetic appearance. In this case, the surgery can be performed in one procedure to minimize patient morbidity.
多指畸形是四肢最常见的先天性畸形。然而，患者双上肢同时出现轴前和轴后多指并伴有并指畸形的情况较为罕见，针对此类病症的建议也有限。本报告介绍了一例双足轴前和轴后多指并伴有并指畸形的病例。
一名2岁女童因双足脚趾数量过多以及第二和第三脚趾之间存在异常连接前来就诊。经过体格检查和X线平片检查，该患者被诊断为双足轴前和轴后多指并伴有并指畸形。我们进行了一期手术矫正，包括切除双侧大脚趾和小脚趾的多余趾头，随后采用Z成形术松解并指。手术过程顺利，患儿家长对手术结果满意。
术前规划需要进行X线平片检查。为了达到最佳功能并兼顾美观，我们舍弃了多余的趾头以及相关的软硬组织。保留软组织、切除副趾、重新排列趾头并修复韧带以保持趾头稳定性是很有必要的。
该病例的复杂性需要采取细致的手术方法来解决结构异常、恢复功能并改善外观。在此病例中，可通过一次手术来尽量减少患者的发病风险。
