Abstract
Amaç: Çalışmamızda Wassel tip IV başparmak duplikasyonlu hastalarda cerrahi rekonstrüksiyon sonuçlarını değerlendirmeyi amaçladık.
Çalışma planı: Ortalama takip süresi 76.9 aydı. Objektif değerlendirmeler Tada skorlama sistemi’nin Horii modifikasyonu ve ALURRA skorlama sistemi kullanılarak yapıldı. Başparmak uzunluğu, başparmak genişliği, metakarpofalangeal ve interfalangeal eklemlerin hareket açıklıkları ve bu eklemlerin açısal deformiteleri değerlendirildi.
Bulgular: Ortalama ALURRA skoru 21 (dağılım; 16–24), Tada skoru ise 5.25 (dağılım; 2–7) olarak hesaplandı. Opere edilen başparmağın uzunluğu karşı taraf başparmağının yaklaşık %95’i, çevresi %89’u, tırnak genişliği ise %80’i olarak hesaplandı. Ortalama hareket açıklıkları interfalengeal eklemde etkilenmeyen tarafın %75.1’i, metakarpofalangeal eklemde ise %80.1’i idi. Metakarpofalangeal eklem dizilim bozukluğu derecelerinin Tada, ALURRA ve GAS skorlarıyla istatistiksel olarak anlamlı negatif korelasyonu olduğu görüldü.
Çıkarımlar: Wassel tip IV başparmak duplikasyonlarında cerrahi rekonstrüksiyon fonksiyonel ve stabil bir başparmak kazandırabilir. Açısal deformite ve kozmetik görünüm hasta tatmin seviyesini etkileyebilir.
References
- Townsend DJ, Lipp EB Jr, Chun K, Reinker K, Tuch B. Thumb duplication, 66 years’ experience-a review of surgical complications. J Hand Surg Am 1994;19:973-6.
- Al-Qattan MM. The distribution of the types of thumb polydactyly in a Middle Eastern population: a study of 228 hands. J Hand Surg Eur Vol 2010;35:182-7.
- Andrew JG, Sykes PJ. Duplicate thumbs: a survey of results in twenty patients. J Hand Surg Br 1988;13:50-3.
- Mih AD. Complications of duplicate thumb reconstruction. Hand Clin 1998;14:143-9.
- Dobyns JH, Wood VE, Bayne LG. Congenital hand deformities. In: Green DP, editor. Operative hand surgery. 3rd ed. New York: Churchill Livingstone; 1993. p. 2515
- Kozin SH. Reconstruction of Wassel type IV thumb duplication. Tech Hand Up Extrem Surg 2010;14:58-62.
- Tada K, Yonenobu K, Tsuyuguchi Y, Kawai H, Egawa T. Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases. J Bone Joint Surg Am 1983;65:584-98.
- Tonkin MA, Bulstrode NW. The Bilhaut-Cloquet procedure for Wassel types III, IV and VII thumb duplication. J Hand Surg Eur Vol 2007;32:684-93.
- Benatar N. Thumb duplication - simple surgery for a common problem? Handchir Mikrochir Plast Chir 2004;36:137-40.
- Cooney WP, Wolf J, Holtkamp K, Dobyns JH. Congenital duplication of the thumb. Handchir Mikrochir Plast Chir 2004;36:126-36.
- Horii E, Nakamura R, Sakuma M, Miura T. Duplicated thumb bifurcation at the metacarpophalangeal joint level: factors affecting surgical outcome. J Hand Surg Am 1997;22:671-9.
- Goldfarb CA, Patterson JM, Maender A, Manske PR. Thumb size and appearance following reconstruction of radial polydactyly. J Hand Surg Am 2008;33:1348-53.
- Ganley TJ, Lubahn JD. Radial polydactyly: an outcome study. Ann Plast Surg 1995;35:86-9.
- Iwasawa M, Noguchi M, Mishima Y, Fujita K. Long-term
Abstract
Objective: The aim of this study was to review the results of patients with Wassel type IV thumb duplication, treated with a single reconstructive procedure.
Methods: The mean follow–up period was 76.9 months. Objective assessments were carried out using Horii modification of Tada scoring system and ALURRA scoring system. Thumb length, thumb girth, range of motion of metacarpophalangeal (MCP) and interphalangeal (IP) joints and angular deformities at MCP and IP joints were evaluated.
Results: The mean ALURRA score was 21 (range; 16–24) and Tada Score 5.25 (range; 2–7). The length of the operated thumb was approximately 95%, the girth 89% and nail width 80% of the non–operated side. The mean range of motion was 75.1% of the unaffected thumb in interphalangeal joint and 80.1% in metacarpophalangeal joint. Metacarpophalangeal joint malalignment had shown statistically significant negative correlation with the scores of Tada, ALURRA and VAS.
Conclusion: Surgical reconstruction may provide a functional and stable thumb in Wassel type IV thumb duplications. The satisfaction of patients is affected by angular deformity of thumbs and cosmetic outlook.
References
- Townsend DJ, Lipp EB Jr, Chun K, Reinker K, Tuch B. Thumb duplication, 66 years’ experience-a review of surgical complications. J Hand Surg Am 1994;19:973-6.
- Al-Qattan MM. The distribution of the types of thumb polydactyly in a Middle Eastern population: a study of 228 hands. J Hand Surg Eur Vol 2010;35:182-7.
- Andrew JG, Sykes PJ. Duplicate thumbs: a survey of results in twenty patients. J Hand Surg Br 1988;13:50-3.
- Mih AD. Complications of duplicate thumb reconstruction. Hand Clin 1998;14:143-9.
- Dobyns JH, Wood VE, Bayne LG. Congenital hand deformities. In: Green DP, editor. Operative hand surgery. 3rd ed. New York: Churchill Livingstone; 1993. p. 2515
- Kozin SH. Reconstruction of Wassel type IV thumb duplication. Tech Hand Up Extrem Surg 2010;14:58-62.
- Tada K, Yonenobu K, Tsuyuguchi Y, Kawai H, Egawa T. Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases. J Bone Joint Surg Am 1983;65:584-98.
- Tonkin MA, Bulstrode NW. The Bilhaut-Cloquet procedure for Wassel types III, IV and VII thumb duplication. J Hand Surg Eur Vol 2007;32:684-93.
- Benatar N. Thumb duplication - simple surgery for a common problem? Handchir Mikrochir Plast Chir 2004;36:137-40.
- Cooney WP, Wolf J, Holtkamp K, Dobyns JH. Congenital duplication of the thumb. Handchir Mikrochir Plast Chir 2004;36:126-36.
- Horii E, Nakamura R, Sakuma M, Miura T. Duplicated thumb bifurcation at the metacarpophalangeal joint level: factors affecting surgical outcome. J Hand Surg Am 1997;22:671-9.
- Goldfarb CA, Patterson JM, Maender A, Manske PR. Thumb size and appearance following reconstruction of radial polydactyly. J Hand Surg Am 2008;33:1348-53.
- Ganley TJ, Lubahn JD. Radial polydactyly: an outcome study. Ann Plast Surg 1995;35:86-9.
- Iwasawa M, Noguchi M, Mishima Y, Fujita K. Long-term
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Article |
| Authors | |
| Publication Date | April 21, 2014 |
| Published in Issue | Year 2014 Volume: 48 Issue: 2 |