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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Pathology and treatment of deviation deformity of thumb after radial polydactyly resection

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  • presenting/speaker Yanhua Chen - Department of Hand Surgery, Union Hospital, Wuhan, China
  • Zhengbin Chen - Department of Hand Surgery, Union Hospital, Wuhan, China
  • Guangxiang Hong - Department of Hand Surgery, Union Hospital, Wuhan, China
  • Xiaobing Cong - Department of Hand Surgery, Union Hospital, Wuhan, China

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. DocIFSSH19-922

doi: 10.3205/19ifssh1365, urn:nbn:de:0183-19ifssh13655

Published: February 6, 2020

© 2020 Chen 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/.

Outline

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Objectives/Interrogation: Radial polydactyly is one of the most common congenital deformity that affect the hand. It has complex anatomic and morphologic features. So the residual thumb deformities usually be seen after radial polydactyly resection. The deviated thumbs are the most common. To the thumb, axis deformity can not be accepted by patients and parents because this kind of deformity seriously affects the function and aesthetics of the hand. We analysis the pathology of deviated thumbs to prevent and treat the axis deformity of the residual thumb.

Methods: A total of 62 deviated thumbs in 58 patients who were treated surgically from 2013 to 2018 were included in this series. The abnormal bone, ligament and tendon were recorded. All patients underwent surgical treatment based on the pathology of deviation. The surgical outcomes were assessed using the Modified Tada score.

Results and Conclusions: Of the 62 deviated thumb cases, 34 (55%) had a abnormal tendon insertion into distal phalanx from flexor pollicis longus, 26 (42%) had no normal insertion of abductor pollicis brevis, and 16 (26%) were triphalangeal thumb. In the evaluation of the surgical outcomes, 51 (82%), 9 (15%) and 2 (3%) were rated as good, fair and poor, respectively.

In the thumb that has two phalanges, the main reason contributed to thumb deviation is the abnormal insertion of the thumb muscles. In the children, resetting the insertion of the thumb muscles can avoid the remarkable axis deformity.