Wassel tip IV başparmak duplikasyonunda cerrahi rekonstrüksiyon

Öz

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.

Anahtar Kelimeler

• Başparmak duplikasyonu; polidaktili; el deformitesi; konjenital; tenodez; amputasyon.

Surgical reconstruction in Wassel type IV thumb duplication

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.

Keywords

• Thumb duplication
• polydactyly
• hand deformities
• congenital
• tenodesis
• amputation

Kaynakça

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