JIA Zhong wei,BAI De ming,LONG Jiang tao,et al.Operative opportunity of the polydactyly in children[J].Journal of Clinical Pediatric Surgery,,12():181-183.[doi:10.3969/j.issn.1671—6353.2013.03.005]
Operative opportunity of the polydactyly in children
- Keywords:
- Ｐｏｌｙｄａｃｔｙｌｙ／ＣＮ; Ｐｏｌｙｄａｃｔｙｌｙ／ＳＵ
- Abstract:
- Objetive To investigate the operative opportunity of the polydactyly in children.MethodsA clinical study was performed on 119 fingers of the 102 patients (including 67 males，35 females；mean age 162±2.36 years；range 2 months to 13 years；left hands was involved in 23 cases， the right one in 62 cases， and both hands in 17 cases；5 case with syndactyly) of polydactyly were surgical treated from August 2008 to December 2011. All patients underwent detailed physical examination and radiological assessment，surgical methods should be selected according to the age， Wassel classification and deformity of the patient. treatment included resection of the most hypoplastic thumb，followed by a variety of skin flap plasty， tendon shift(transplantation)， reinsertion of the collateral ligament and the articular capsule， part of the older children underwent osteotomy discretion as appropriate.ResultsA total of 94 fingers of the 81 patients (79.4%) were followed up for an average 11.6 months (range，3~27)，based on the upgrade Tada scoring system，the results were excellent in 62，good in 17，fair in 12 and poor in 3. Two thumbs appear secondary angular deformities after postoperative two years， and one thumb residual epiphysis of the radial side of metacarpophalangeal joint after three years， the appearance and function had been nearly normal after second operation.ConclusionThe optimal surgical timing of polydactyly should be based on the ossification center of thumb appears， The complex polydactyly that severe malformations and structural variation should strictly control the optimal surgical timing， preoperative assessment of the conditions and formulate the individualized treatment programs for children， good performance during surgery and longterm regular followup after operation.
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