背景:在文献中,关于后轴多指的手术治疗没有共识,很少报道多指多指症。完全畸形的治疗将防止进一步的足部和步态障碍。
目的:从临床经验的角度,确定与Y型跖骨双指骨第六趾手术治疗及相关皮肤和伤口护理相关的文献,以改善手术治疗方案。
方法:作者在2022年12月搜索了几个电子数据库,以查找与脚中的后轴多指症和多and症有关的文章。搜索的数据库包括PubMed,SciELO,ScienceDirect,Cochrane系统评价数据库,和谷歌学者灰色文学。
方法:两名独立研究人员进行了搜索并阅读了文章标题和摘要。如果研究是叙事评论,案例研究,或观察性研究;用英语或西班牙语撰写;并在2012年至2022年之间发表。非人类研究被排除在外。对符合纳入标准的研究进行全面评估。审稿人之间的分歧以协商一致方式解决,当没有共识时,咨询了一名高级研究员。
方法:使用标准化形式从纳入的研究中提取以下数据:作者和发表年份,研究类型,参与人数,性别,多指位置,多跖骨,多指类型,参与者有遗传性相关疾病或畸形的病史,治疗,删除标准,和手术时机。
结果:作者评估了11项关于后轴多指的研究,共包括153名参与者(64名男性,89名妇女)。他们还记录了他们使用手术技术的临床经验,该手术技术用于足的双侧后轴多指,带有Y形and骨第六趾。
结论:第六趾外侧切除手术矫正是改善足部功能的一种决定性治疗方法,它的美学外观,和病人的生活质量。应应用和定制针对具体病例的治疗,以满足个人需求。这些患者的步态和鞋子问题的生物力学通过手术治疗得到改善,在皮肤护理中不会出现二次美学问题。
BACKGROUND: In the literature, there is no consensus regarding the surgical management of postaxial
polydactyly, and few cases of polymetatarsia with
polydactyly have been reported. Treatment of the complete deformity will prevent further foot and gait disorders.
OBJECTIVE: To identify literature relevant to the operative management of Y-shaped metatarsal with biphalangeal sixth toe and related skin and wound care to improve surgical treatment protocols from a clinical experience perspective.
METHODS: The authors searched several electronic databases in December 2022 for articles related to postaxial polysyndactyly in the feet and polymetatarsia. Databases searched included PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and Google Scholar gray literature.
METHODS: Two independent researchers conducted the searches and read the article titles and abstracts. Studies were included if they were narrative reviews, case studies, or observational studies; written in English or Spanish; and published between 2012 and 2022. Nonhuman studies were excluded. Studies that met the inclusion criteria were fully evaluated. Disagreements between reviewers were resolved by consensus, and when there was no consensus, a senior researcher was consulted.
METHODS: The following data were extracted from the included studies using a standardized form: author and year of publication, study type, number of participants, sex,
polydactyly location, polymetatarsia, type of
polydactyly, participants\' history of hereditary associated diseases or malformations, treatment, removal criteria, and timing of surgery.
RESULTS: Authors evaluated 11 studies of postaxial
polydactyly that included a total of 153 participants (64 men, 89 women). They also document their clinical experience with a surgical technique used in cases of bilateral postaxial polydactyly of the foot with a Y-shaped metatarsal with biphalangeal sixth toe.
CONCLUSIONS: Surgical correction with lateral removal of the sixth toe is a resolutive treatment to improve the functionality of the foot, its aesthetic appearance, and the patient\'s quality of life. Case-specific treatment should be applied and tailored to meet the individual needs. The biomechanics of gait and shoe problems in these patients improve with surgical treatment, without presenting secondary aesthetic problems in skin care.