Abstract：
BACKGROUND: Radial Polydactyly Type IV-D deformity is difficult to treat because of the most complex bone and soft tissue anomalies. Resection and reconstruction for one of the two thumbs was an option for treatment.
OBJECTIVE: The study was to present our method of resection and reconstruction with a new incision for radial polydactyly Type IV-D and evaluate the clinical efficacy comprehensively using Rotterdam assessment system in a large sample.
METHODS: 206 cases of type IV-D thumb duplication underwent resection and reconstruction surgical treatment between 2010 and 2019. Two equal triangle flap incisions were designed around the radial thumb. The radial thumb was resected and the ulnar thumb was reconstructed in aspects of bone, tendons, ligaments and abductor pollicis brevis. The clinical results were evaluated using Rotterdam assessment system.
RESULTS: The mean follow-up period was 2.2 years (SD 1.5). The mean age of the patients was 9 months (SD 1.8) at the time of operation. The mean ranges of active IP and MP joint flexion and extension were 110° and 26°. The mean angulations for IP and MP joint instabilities were 3° and 11°, relatively. Angulation for palmar abduction was 58°. The mean appearance domain score was 8.9. The average parental satisfaction score was 2.5 and the average patient-reported pain score was 2.1. The mean functional domain score for all patients was 6.6. The average appearance domain score was 8.9. The mean patient-reported domain score was 4.5. The mean Rotterdam outcome score was 20.0, equivalent to 67% of the full score. The postoperative score of patients over two years old was significantly lower than that of patients under two years old.
CONCLUSIONS: Resection and reconstruction method with two equal triangle flap incisions was a recommended treatment for radial polydactyly Type IV-D.
METHODS: IV.
OBJECTIVE: The study was to present our method of resection and reconstruction with a new incision for radial polydactyly Type IV-D and evaluate the clinical efficacy comprehensively using Rotterdam assessment system in a large sample.
METHODS: 206 cases of type IV-D thumb duplication underwent resection and reconstruction surgical treatment between 2010 and 2019. Two equal triangle flap incisions were designed around the radial thumb. The radial thumb was resected and the ulnar thumb was reconstructed in aspects of bone, tendons, ligaments and abductor pollicis brevis. The clinical results were evaluated using Rotterdam assessment system.
RESULTS: The mean follow-up period was 2.2 years (SD 1.5). The mean age of the patients was 9 months (SD 1.8) at the time of operation. The mean ranges of active IP and MP joint flexion and extension were 110° and 26°. The mean angulations for IP and MP joint instabilities were 3° and 11°, relatively. Angulation for palmar abduction was 58°. The mean appearance domain score was 8.9. The average parental satisfaction score was 2.5 and the average patient-reported pain score was 2.1. The mean functional domain score for all patients was 6.6. The average appearance domain score was 8.9. The mean patient-reported domain score was 4.5. The mean Rotterdam outcome score was 20.0, equivalent to 67% of the full score. The postoperative score of patients over two years old was significantly lower than that of patients under two years old.
CONCLUSIONS: Resection and reconstruction method with two equal triangle flap incisions was a recommended treatment for radial polydactyly Type IV-D.
METHODS: IV.
摘要：
背景：由于最复杂的骨骼和软组织异常，难以治疗放射状多指IV-D型畸形。切除和重建两个拇指之一是治疗的一种选择。
目的：本研究提出了一种新的切口切除和重建IV-D型放射状多指的方法，并使用鹿特丹评估系统在大样本中综合评价临床疗效。
方法：2010-2019年对206例IV-D型拇指重复行切除重建手术治疗。围绕the拇指设计了两个相等的三角形皮瓣切口。切除桡骨拇指，重建尺骨拇指，肌腱,韧带和拐卖者Pollicisbrevis.使用鹿特丹评估系统评估临床结果。
结果：平均随访期为2.2年（标准差1.5）。手术时患者的平均年龄为9个月（SD1.8）。活动IP和MP关节屈伸的平均范围为110°和26°。IP和MP关节不稳定性的平均角度为3°和11°，相对而言。手掌外展的角度为58°。平均外观域评分为8.9。父母满意度平均评分为2.5，患者报告的疼痛平均评分为2.1。所有患者的平均功能域评分为6.6。平均外观域评分为8.9。患者报告的平均领域评分为4.5。鹿特丹结果的平均得分为20.0分，相当于满分的67%。2岁以上患者术后评分明显低于2岁以下患者。
结论：两个等三角形皮瓣切口的切除和重建方法是放射状多指IV-D型的推荐治疗方法。
方法：IV.
目的：本研究提出了一种新的切口切除和重建IV-D型放射状多指的方法，并使用鹿特丹评估系统在大样本中综合评价临床疗效。
方法：2010-2019年对206例IV-D型拇指重复行切除重建手术治疗。围绕the拇指设计了两个相等的三角形皮瓣切口。切除桡骨拇指，重建尺骨拇指，肌腱,韧带和拐卖者Pollicisbrevis.使用鹿特丹评估系统评估临床结果。
结果：平均随访期为2.2年（标准差1.5）。手术时患者的平均年龄为9个月（SD1.8）。活动IP和MP关节屈伸的平均范围为110°和26°。IP和MP关节不稳定性的平均角度为3°和11°，相对而言。手掌外展的角度为58°。平均外观域评分为8.9。父母满意度平均评分为2.5，患者报告的疼痛平均评分为2.1。所有患者的平均功能域评分为6.6。平均外观域评分为8.9。患者报告的平均领域评分为4.5。鹿特丹结果的平均得分为20.0分，相当于满分的67%。2岁以上患者术后评分明显低于2岁以下患者。
结论：两个等三角形皮瓣切口的切除和重建方法是放射状多指IV-D型的推荐治疗方法。
方法：IV.
