Han Qinyi, Liu Fanxiao, Zhang Guiping, Wang Dehua
From the Department of Hand and Foot, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Plast Reconstr Surg Glob Open. 2025 Mar 12;13(3):e6545. doi: 10.1097/GOX.0000000000006545. eCollection 2025 Mar.
This study aimed to investigate the clinical effects of bone fusion distal to the phalangeal epiphyseal plate in treating asymmetrical type III thumb polydactyly, focusing on growth and scar healing.
In patients with asymmetrical type III thumb syndactyly, the proximal phalanx of the accessory finger, distal epiphyseal plate, and some soft tissue were excised to create a pedicled tissue flap. This flap, containing part of the nail and bone distal to the epiphyseal plate, was subsequently attached to the distal segment of the main finger. The therapeutic effect was evaluated during follow-up.
Ten children (6 boys and 4 girls) were included, with follow-up periods ranging from 24 to 60 months. All parents expressed satisfaction with the appearance and function of reconstructed thumbs. All reconstructed thumbs utilizing pedicled composite tissue flaps survived without arteriovenous crises, and there were no instances of perioperative mortality or wound infection. Compared with the contralateral normal thumb, most reconstructed thumbs exhibited good alignment and similar length and circumference. The reconstructed nails demonstrated a smooth surface with an appropriate curvature of the nail margin. The interphalangeal (IP) joint remained stable, and no instability of the IP joint collateral ligament was observed. The active and passive ranges of motion of the IP joint were satisfactory, and the epiphyseal plate of the reconstructed thumb was well-developed.
This method is considerably effective in reconstructing asymmetrical type III thumb duplication through fusion of bone distal to the phalangeal epiphyseal plate.
本研究旨在探讨指骨骨骺板远端骨融合术治疗不对称III型拇指多指畸形的临床效果，重点关注生长和瘢痕愈合情况。
对于不对称III型拇指并指畸形患者，切除副指近节指骨、远端骨骺板及部分软组织，形成带蒂组织瓣。该组织瓣包含骨骺板远端的部分指甲和骨质，随后将其附着于主指远端。随访期间评估治疗效果。
纳入10例儿童（6例男孩，4例女孩），随访时间为24至60个月。所有家长对重建拇指的外观和功能表示满意。所有采用带蒂复合组织瓣重建的拇指均存活，未发生动静脉危象，无围手术期死亡或伤口感染情况。与对侧正常拇指相比，多数重建拇指排列良好，长度和周长相似。重建指甲表面光滑，甲缘曲率合适。指间关节保持稳定，未观察到指间关节侧副韧带不稳定。指间关节的主动和被动活动范围满意，重建拇指的骨骺板发育良好。
通过指骨骨骺板远端骨融合术重建不对称III型拇指重复畸形，该方法效果显著。
