Otsuka Junko, Horii Emiko, Koh Shukuki, Takeshige Hiroki
From the Department of Orthopedic Surgery, Japanese Red Cross, Aichi Medical Center, Nagoya Daiichi Hospital, Nagoya, Aichi, Japan.
Department of Orthopedic Surgery, Kansai Medical University Hospital, Hirakata, Osaka, Japan.
Plast Reconstr Surg Glob Open. 2025 Jan 21;13(1):e6463. doi: 10.1097/GOX.0000000000006463. eCollection 2025 Jan.
The objective of this study was to propose a novel classification for lateral polydactyly of the foot that integrates both visual appearance and radiographic findings and to delineate surgical techniques and their outcomes based on this classification.
This study enrolled 148 feet from 126 patients who underwent initial surgery at our hospital between January 2009 and July 2021. The new classification system was derived from visual appearance according to the Hirase classification and radiological bifurcation level (D: distal or middle phalanx, P: proximal phalanx, and M: metatarsal). Incidence rates, surgical procedures, and surgical outcomes were compared across each type.
Morphologically, 25 cases were classified as type A, 43 cases as type B1, and 80 cases as type B2. The branching level was categorized as D in 81 feet, P in 41 feet, and M in 26 feet, with 68 feet (46%) classified as B2-D type. Excision of the sixth toes was performed in all type A cases, whereas the majority of type B cases required excision of the fifth toes. Revision procedures were conducted on 8 feet. Three patients with type A-P classification developed painful hammer toe deformities as a late sequela that necessitated extensor tenolysis and metatarsophalangeal joint contracture release during their school-age years.
The classification system based on the combination of visual appearance and radiological branching level was both straightforward and beneficial for surgical planning and for predicting surgical outcomes and late sequelae.
本研究的目的是提出一种新颖的足部外侧多指畸形分类方法，该方法整合了外观和影像学表现，并基于此分类描述手术技术及其结果。
本研究纳入了2009年1月至2021年7月期间在我院接受初次手术的126例患者的148只脚。新的分类系统源自根据平濑分类法的外观以及放射学分叉水平（D：远节或中节趾骨，P：近节趾骨，M：跖骨）。比较了每种类型的发病率、手术方式和手术结果。
形态学上，25例被分类为A型，43例为B1型，80例为B2型。分叉水平分类为D的有81只脚，P的有41只脚，M的有26只脚，其中68只脚（46%）被分类为B2-D型。所有A型病例均进行了第六趾切除，而大多数B型病例需要切除第五趾。对8只脚进行了翻修手术。3例A-P型分类患者出现疼痛性槌状趾畸形作为晚期后遗症，在学龄期需要进行伸肌腱松解和跖趾关节挛缩松解。
基于外观和放射学分叉水平相结合的分类系统既简单又有助于手术规划以及预测手术结果和晚期后遗症。
