Clinical Retrospective Study Of Congenital Thumb Deformity

The retrospective study of Congenital duplicate thumb deformitiesObjectiveTo summarize the surgical treatment experience of congenitalthumb duplication by our hospital, and to discuss the etiology andprevention of secondary surgery.MethodsThe clinical data of84cases of Congenital thumb malformationfrom2001to2013were summaried, After long-term follow-up of75cases, follow-up time is2to10years, an average of4.8years,Retrospect and analyze the pathogenic site，Clinical classification，Operation Timing,surgical procedures and the cause of thesecondary deformities after primary respair.ResultsThis group of84cases, male54cases,30cases of female, sexratio of1.8:1,40cases in left hand,28cases in right hand,16casesin both sides. A genetic history of23cases, Non-genetic history of61cases; According to Wassel classification: Ⅰ type8cases, Ⅱtype12cases, type Ⅲ18patients, Ⅳ type26cases, type Ⅴ8cases, Ⅵ type5cases, Ⅶ type2cases, floating thumb5cases.Operating time by2months after birth to8years old, among them2months after birth to six months operation of8cases（4cases postoperative secondary deformity）,42cases of6months-1yearold（8cases postoperative secondary deformity）,25cases of1-2years old age（2cases postoperative secondary deformity）,9cases ofage2to13years old（1cases postoperative secondary deformity）. InSurgical method,13cases by Bilhaut-Cloquet method(1casespostoperative secondary deformity),12cases by Simple removePolydactylism (2cases postoperative secondary deformity),15casesby Simple osteotomy (7cases postoperative secondary deformity),6cases by Osteotomy combined extensor, flexor tendon reconstruction(1cases postoperative secondary deformity),34cases by Osteotomycombined short abductor hallucis ended point reconstruction (4casespostoperative secondary deformity),2cases by tiger’s mouthreconstruction,2cases by Osteotomy with interphalangealarthrodesis.15cases Postoperative deformity use secondary tosurgical treatment, this group accounted for17.8%of the total cases.Epiphyseal residual in2cases, Tiger’s mouth contracture andstenosis in2cases, bending axis in5cases, thumb Weakness ofStretch and Flexion’s strength in2cases, thumb on the palmweakness in2cases. A Wrong in1case. According to Kawabata’srating system, the operative results were graded as excellent in51cases, good in9cases, and poor in15cases, Fine rate was80%.15cases with secondary deformities after primary respair under re-debulking surgery, excellent in10cases, good in5cases.ConclusionCongenital thumb deformities caused by genetic and acquiredfactors，while the number of cases of acquired teratogenic factors areincreasing year by year, acquired teratogenic factors may beassociated with the environment, diet, medications, viral infections,exposure to radiation，etc. Congenital thumb deformities existed thethumb nearly section, most Belong near section phalanx type in pairs(Wassel Ⅳ type), Paired type with Split type’s postoperativedeformity rate is no significant difference. The group proved thatSurgical treatment time should be well as soon as possible, it shouldbe chosed to start two months after birth, more appropriate for sixmonths after birth and compled all surgery in two years, which canboth ensure the safe and reliable surgical procedure, but also notimpact on children’s the psychology, while is significant withchildren’s thumb functional early plastic. There are many factors cancause the secondary deformity in early after orthopaedic surgery,such as the surgeon to identify the epiphysis Structure is unclear, theremnants caused by improper operation, osteotomy is not enough,muscle power systems have not been rebuilt, it should focus onimproving the overall level of operation on the surgeon and accuratepreoperative fine judgments to reduce reoperation rates.