Application of the nail ridge formation for the wassel type Ⅰ and type Ⅱ thumb duplication with connected nail
10.3760/cma.j.issn.1009-4598.2019.07.007
- VernacularTitle: 甲缘成形术在指甲相连的Wassel Ⅰ、Ⅱ型多指畸形整复中的应用
- Author:
Chao KONG
1
;
Jun XIAO
;
Tianwu LI
;
Lin QIU
;
Yuexian FU
;
Xiaofei TIAN
Author Information
1. Department of Burn and Plastic Surgery, Children′s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
- Publication Type:Clinical Trail
- Keywords:
Wassel Type Ⅰ and Ⅱ thumb;
Connected nail;
Surgery;
Nail ridge formation
- From:
Chinese Journal of Plastic Surgery
2019;35(7):649-653
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To report the clinical outcome for Wassel Type I and Ⅱ thumb duplication with connected nail by excising the extra digit and reconstructing of nail ridge with the flap from the ablated digit.
Methods:63 polydactyly of the thumbs in 61 patients with connected nail were treated the procedure by excising of the inferior phalangeal bones and nails and straightening the IP joint by orthroplasty or wedge osteotomy and reconstructing the nail ridge with the flap from the extra digit. The patients were followed up postoperatively for the assessment of thumb′s appearance and function by using the modified TADA scoring.
Results:All cases acquired primary wound healing and 55 of 63 cases were followed up for 6 months to 4 years. The nails were flat and the width were more than 80% of the contralateral side. Symmetric nail lunula was found in 46 thumbs (80.7%) as well as symmetric nail ridge in 40 thumbs (70.1%), but 50 thumb′s nail grooves were not obvious (87.7%). All incisions were made at the lateral of thumbs and no scars were found in the finger pulps. Except mild IP joint deviation was found in 6 thumbs, the others were roughly normal. The range of motion of the IP joint was more than 45° in all cases. Modified TADA scoring result: 52 fingers were excellent and 5 were good.
Conclusions:Satisfactory surgical outcome and better parental acceptance can be obtained after the procedures of excising the extra digit and forming of nail ridge, including aesthetics appearance, unaffected sense of touch with finger pulp intact and good mobility of the joint.
