Purpose: Postoperative deviation (PD) is a complicated and troublesome complication after polydactyly reconstruction. We aim to investigate the clinical efficacy of a novel revision surgery, reconstruction of the balance of bone and soft tissue, treating PD after radial polydactyly reconstruction in comparison with a previous surgical plan.
Methods: We reconstructed the balance of bone and soft tissue to correct PD and the asymmetrical appearance of the thumb. At the follow-up, we used the digital circumferential ratio (reconstructive/healthy side), Vancouver Scar Scale (VSS) score, Japanese Society for Surgery of the Hand (JSSH), aesthetic scoring system (ASS) modified Tada score and range of motion (ROM) to evaluate the appearance and function outcomes.
Results: Seventeen PD patients received our new surgical plan (NG), and 31 patients received the traditional surgical plan (CG). There was no significant difference in gender, age, site of hand and follow-up period, as well as preoperative digital circumference ratio, deviation angle of metacarpophalangeal joints (MP) and interphalangeal joint (IP). At the final follow-up, we found that digital circumference ratio, JSSH and ASS were obviously higher in NG than in CG, implying that our novel surgical plan can provide good aesthetics and excellent postoperative function.
Conclusions: The reconstructive balance of bone and soft tissue can effectively improve the appearance and function of PD after polydactyly reconstruction. Mastering the indications for surgery and good microsurgical techniques are the keys to ensuring therapeutic effects.
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http://dx.doi.org/10.1186/s13018-025-05611-8 | DOI Listing |
J Plast Reconstr Aesthet Surg
February 2025
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Orthopaedics, Wenzhou, Zhejiang, China. Electronic address:
Surgical treatment of Wassel type Ⅵ radial polydactyly with convergent deformity is technically challenging. We found that 17 of our cases exhibited cartilaginous connections between the bases of the radial and ulnar thumb's metacarpals. To better assess the anatomic features and guide surgical design, we used X-ray and MRI imaging to characterize the adduction of the ulnar metacarpal, radial subluxation of the metacarpophalangeal joint, narrowness of the first web, and thenar muscle distribution.
View Article and Find Full Text PDFPlast Reconstr Surg
February 2025
Division of Plastic & Reconstructive Surgery, Department of Surgery, Spencer Fox Eccles School of Medicine at the University of Utah, and Intermountain Primary Children's Hospital, Salt Lake City, UT.
Introduction: Type A ulnar/postaxial polydactyly describes a well-developed supernumerary small finger, which may have self-image and functional sequelae even after reconstructive surgery. We aimed to characterize postoperative outcomes and substantiate the CoULD Ulnar Polydactyly (CUP) Classification's clinical relevance.
Methods: All cases at two major pediatric hospitals from 2012-2022 were reviewed.
Cureus
January 2025
Department of Plastic, Reconstructive, and Hand Surgery, University of Tsukuba, Tsukuba, JPN.
Two factors contribute to the stability of the thumb: static stability provided by the bones, joints, and ligaments, and dynamic stability provided by the muscles. Proximal types of polydactyly, such as Wassel types Ⅴ and Ⅵ, are often associated with thenar dysplasia, which is thought to lack sufficient dynamic stability. Therefore, in cases of proximal polydactyly where instability at the metacarpophalangeal (MCP) joint is severe, static stability becomes important.
View Article and Find Full Text PDFJ Orthop Surg Res
March 2025
Orthopaedics Department, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, People's Republic of China.
Purpose: Postoperative deviation (PD) is a complicated and troublesome complication after polydactyly reconstruction. We aim to investigate the clinical efficacy of a novel revision surgery, reconstruction of the balance of bone and soft tissue, treating PD after radial polydactyly reconstruction in comparison with a previous surgical plan.
Methods: We reconstructed the balance of bone and soft tissue to correct PD and the asymmetrical appearance of the thumb.
Indian J Plast Surg
December 2024
Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
Postaxial polydactyly (PAP) in the form of rudimentary soft tissue masses is quite common. Management involves ligation or surgical excision. Rarely do literature discussions cover complex variants in which the extra finger is fully developed.
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