Wassel Ⅳ thumb polydactyly with 3-DEEP treatment strategy
10.3760/cma.j.cn114453-20200601-00332
- VernacularTitle:Wassel Ⅳ型拇指多指畸形的3-DEEP治疗策略
- Author:
Ruibin HU
1
;
Danya ZHOU
;
Liang ZHU
;
Xin WANG
Author Information
1. 宁波市第六医院整形（修复重建）外科 315040
- Keywords:
Thumb;
Polydactyly;
Osteotomy;
Tendon
- From:
Chinese Journal of Plastic Surgery
2020;36(7):734-738
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce the 3-DEEP treatment strategy for Wassel Ⅳ thumb polydactyly and evaluate the clinical efficacy of this treatment strategy.Methods:A retrospective study of Ningbo Sixth Hospital between January 2010 and December 2019 in Wassel Ⅳ thumb polydactyly cases, 153 cases of 155 thumbs, according to the appearance and the X-ray image to be subdivided into type A (balanced type, crab claw shaped), 16 cases; type B (disequilibrium, the thumb joint deviation less than 25 degrees), 97 cases ; and type C (disequilibrium, the thumb joint deviation greater than 25 degrees) , 42 cases. The thumb plastic surgery was divided into three layers: bone and joint, tendon and muscle, and skin-soft-tissue for personalized design (3-DEEP). Postoperative follow-up was conducted to evaluate the efficacy and satisfaction, and complications were observed.Results:153 patients were followed up for 1 to 6 years, and the efficacy evaluation was excellent in 104 cases, good in 46 cases, and poor in 5 cases, with the excellent and good rate of 96.8%. The functional satisfaction and shape satisfaction were 98.1% and 96.8% respectively. Among them, 2 cases showed unsatisfactory postoperatively flexion and extension of the interphalangeal joint and interphalangeal joint deviation deformity, 1 case showed radial hump deformity of the metacarpophalangeal joint 2 years after the operation, and 2 cases showed relatively obvious incision scar.Conclusions:Wassel Ⅳ thumb polydactyly is the most common type of thumb polydactyly, but there are still obvious differences in the same classification group.We further subdivided the classification of cases of Wassel type Ⅳ, and according to the anatomical characteristics of each subtype, we designed 3-DEEP treatment strategies, get better thumb appearance, avoid postoperative joint dysfunction, and less postoperative complications.
