The application of on-top-plasty in thumb reconstruction of mirror hand deformity
10.3760/cma.j.cn114453-20200408-00207
- VernacularTitle:顶端移位术在镜影手畸形拇指重建中的应用
- Author:
Hang ZHANG
1
;
Hang XIAN
;
Yongxiang CHEN
;
Changying ZHAO
;
Wenzhi ZHANG
;
Rui CONG
Author Information
1. 空军军医大学西京医院骨科，西安 710032
- Keywords:
Hand deformity;
Mirror hand;
On-top-plasty technique;
Treatment
- From:
Chinese Journal of Plastic Surgery
2020;36(7):743-750
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effect of the on-top-plasty technique in thumb reconstruction of mirror hand deformity.Methods:From Jan 2015 to Jun 2018, five children, diagnosed as mirror hand deformity, were retrospectively analyzed in hand surgery department of Xijing Hospital, male 3 case, female 2 case, the age ranged from 1 year 8 mouths to 5 years 10 mouths. To reconstruct the thumb, the top of the radial digit, which had better appearance and function, was selected and transferred to the proximal part of digit that had good position of metacarpal. The thumb reconstruction function scoring standard in Hand Surgery of Chinese Medical Association (0-15) and Kapandji opposition score (0-10) were applied to evaluate the treatment effect. Using SPSS 19.0 statistical software for statistical analysis, the measurement data were expressed by the mean standard deviation, t test was used to analyze the abduction angle, thumb length, thumb-to-palm and kneading function before and after operation. P<0.05 showed significant difference. Results:All of the five transferred thumbs survived postoperatively. The follow-up interval ranges from 1.5 years to 5.0 years (mean 3.3 years). The shape and function of the reconstructed thumbs were satisfactory at the last follow-up. The pre-operative and post-operative thumb web space were 44.80°±4.02° and 80.60°±8.02° respectively, the length of the thumbs were( 9.02 ±1.56) cm and (5.86 ±0.86) cm respectively, Kapandji opposition score were 3.20±0.84 and 6.60±1.14. All of the pre-operative evaluation indicators above have statistical significance compared with post-operative ones ( P<0.05). The results concluded 2 excellent and 3 good according to the thumb function scoring standards in Hand Surgery of Chinese Medical Association, which have a good above rate of 100%. Conclusions:The application of on-top-plasty technique in thumb reconstruction of mirror hand deformity can achieve good results of the reconstructed thumb both in cosmetic appearance and functional recovery, which obtains satisfactory results from the children and parents.
