| Objective To explore the clinical functions outcome and the operation opportunity of the surgical treatment of congenital thumb duplication．Methods From Nov 2008 to May 2016, thirty-one patients (33 sides) with congenital thumb duplication were treated with individual corrective surgery of 33 thumbs, 1 was rated as typeⅠ, 7 as type Ⅱ, 1 as type Ⅲ, 20 as type Ⅳ, 1 as type Ⅴ, and 3 as type Ⅶ according to Wassel classication. There were 23 males and 8 females，with an average age of 1.8 years (ranged 10 months to 4 years). The duplication was bilateral in 2 patients（one side as type Ⅱ, the other side as type Ⅳ）, on the right side in 23 patients, and on the left side in 10 patients. One patient had a type Ⅶ thumb deformity and a triphalangeal thumb on the other hand.During the operation, the anatomical structure was dissected to observe the structure and alignment of the thumb. The abnormal bone and soft tissue were removed. In the meantime, collateral ligament and joint capsule was reconstructed, the endpoint of the abductor pollicis brevis was shifted. Results Postoperative wound smoothly healed in all patients and no incision complications occurred. All patients were followed up from 6 to 50 months (mean: 26 months). The thumb configuration, the flexion and extension, the function of opposition and abduction were improved in 31 cases. The incision scar at the thumb was small without contraction deformity, small first web space, and secondary deviation deformity. On the X ray film review, the bone union signs were visible at 6 weeks after the osteotomy. We adopted Tien’s modified Tada scoring system to evaluate the follow-up results, the excellent in 26 sides, the good in 6 sides, and poor in 1 side. Conclusion Treatment of congenital with individual corrective surgery can get good results, restore the appearance and function. Based on the anatomical structure, individualized treatment plan and select optimal operation time is very important. |
