gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Surgical strategy for angular deformity correction in thumb polydactyly reconstruction

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  • Pobe Luangjarmekorn - Department of Orthopaedics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
  • Pravit Kitidumrongsook - Department of Orthopaedics, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-37

doi: 10.3205/19ifssh1161, urn:nbn:de:0183-19ifssh11613

Published: February 6, 2020

© 2020 Luangjarmekorn et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objectives/Interrogation: Proposed surgical strategy and analyzed the result of soft tissue reconstruction with or without corrective osteotomy for correction angular deformity in thumb polydactyly surgery.

Methods: Surgical procedures for correction angular deformity of metacarpophalangeal (MCP) and interphalangeal (IP) joint in thumb polydactyly were restrospective reviewed. Classified by degrees of angulation into mild (< 30 degrees) and severe angulation (>30 degrees), the operations and surgical outcomes were analyzed in terms of surgical procedures (soft tissue reconstructions with/without corrective osteotomy), post-operative complications and residual deformity.

Results and Conclusions: 42 thumb polydactyly were reviewed. Six were skin-tag type and treated by simple excision without complications and residual deformity. Other 36 patients were presented with angular deformity of MCP and/or IP joint.

For MCP joint deformity, there was 25 patients had mild MCP angulation (< 30 degrees). All 25 patients were treated by soft tissue reconstruction alone without osteotomy. The result in this group showed residual deformity only 8% (2/25 patients). In severe MCP angulation (>30 degrees), there was 11 patients in this group. Only 6/11 patients (54.5%) achieved proper alignment from soft tissue procedure alone and other 5 patients (45.5%) need metacarpal osteotomy to correct MCP angulation. Prognosis of this group showed residual deformity up to 27.3% (3/11 patients).

For IP joint deformity, there was 27 patients had mild IP angulation (< 30 degrees). All 27 patients were treated by soft tissue reconstruction alone without requiring osteotomy. The result in this group showed no residual deformity. In severe IP angulation (> 30 degrees), there was 9 patients in this group. Only 3/9 patients (33.3%) achieved proper alignment from soft tissue procedure alone and other 6 patients (66.7%) need phalangeal osteotomy to correct IP angulation. Prognosis of this group showed residual deformity up to 77.8% (7/9 patients).

In conclusion,soft tissue reconstruction alone was the effective method for correction angular deformity in mild deformity (< 30 degrees) of MCP and IP joint with low residual deformity (8% for MCP and 0% for IP joint). However,severe angulation (> 30 degrees) of MCP and IP deformity need both soft tissue and corrective osteotomy to achieve proper deformity correction and less predictable results especially in IP joint deformity(long-term residual deformity 27.3% for MCP and up to 77.8% for severe IP joint deformity).