The Zig-Zag Deformity in Pre-Axial Polydactyly

Lourie, Gary M.; Costas, B. L.; Bayne, Loui G.

doi:10.1016/s0266-7681(05)80176-7

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…Five of the 6 type-V polydactyly patients also had joint instability and 3 had joint deformity. Lourie et al 16 also reported Z thumb deformity after simple suture ligation of the radial component of a bifid thumb. As preoperative joint stability was not documented in our study, joint instability might have been due to an inherent defect.…”

Section: Resultsmentioning

confidence: 97%

Thumb Polydactyly: Clinical Outcome after Reconstruction

Yen

Chan

Leung

et al. 2006

J Orthop Surg (Hong Kong)

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Purpose. To evaluate clinical and cosmetic outcomes of reconstruction in thumb polydactyly and prognostic value of the Wassel classification. Methods. Between 1993 and 2000 inclusive, out of the patients with thumb polydactyly (involving 80 thumbs) operated on, 34 patients (36 thumbs) were available for review and underwent clinical and radiological assessment. Outcomes in terms of the Tada score and complications were recorded. Results. The mean age of patients at the time of operation was 2.8 (range, 0.6-47) years. The mean follow-up period was 5 (range, 2.4-10) years. According to the Wassel classification, 12 were type-II thumb polydactyly, 3 type-III, 11 type-IV, 6 type-V, one type-VI, and 3 type-VII. There was no perioperative mortality or wound infection. More than 88% of the patients were satisfied or very satisfied with functional and cosmetic outcomes. Postoperative complications such as scar hypertrophy, pulp atrophy, joint deformity, and instability were common but minor. Ridge nail deformity after the Bilhaut Cloquet procedure was amenable to second- [295][296][297][298][299][300][301][302] ary corrective procedures. All types of operated thumb polydactyly achieved similar mean Tada scores (14.7-16.6 out of 20). The Wassel classification category, age, and surgical procedures were found to have no prognostic value with regard to the Tada score and presence of complications. Conclusion. Surgery on thumb polydactyly is rewarding. The Wassel classification category can be used as a guide for treatment, although it fails to predict the occurrence of postoperative complications or Tada scores. Our patients' results can serve as guidelines of expected outcomes after reconstructive procedures in different sub-types of thumb polydactyly.

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Section: Resultsmentioning

confidence: 97%

Thumb Polydactyly: Clinical Outcome after Reconstruction

Yen

Chan

Leung

et al. 2006

J Orthop Surg (Hong Kong)

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“…Andrew y Sykes 47 revisaron sus 20 casos, de los que tuvieron que reoperar a más de la mitad, especialmente tipos III y IV. Lourie et al 48 señalaron que esta «deformidad en Z» puede aparecer en algún caso de apariencia banal inicialmente.…”

Section: Discussionunclassified

Polidactilias del pulgar. Tratamiento quirúrgico

Oliveira

Ribak

Irisarri³

2016

Rev Iberoam Cir Mano

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Las polidactilias del pulgar, especialmente sus duplicaciones, constituyen una anomalía de frecuente presentación. Sus variantes son múltiples, lo que nos obliga a conocer cuáles son las diferencias anatómicas más relevantes en cada tipo en particular. Han sido muchas sus clasificaciones, pero la propuesta por Wassel, basada en los hallazgos radiológicos, continúa siendo tan simple como práctica. Excepto en los casos más simples, su cirugía reconstructiva es difícil, y debe ser encomendada a cirujanos con experiencia. Aun así, en los casos complejos el resultado dista de ser la obtención de un pulgar «normal», incluso con la técnica de «resección y reconstrucción» que utilizamos y que describimos en el presente artículo. Con frecuencia el tratamiento de las polidactilias se considera como algo simple y banal, y su dificultad real solamente se hace patente con el resultado desastroso de la cirugía. Las complicaciones que pueden presentarse son diversas y, en un significativo número de casos, van a requerir posteriormente una nueva cirugía reconstructiva para mejorar el resultado funcional y/o estético.

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“…Interphalangeal joint deviation in floatingtype radial polydactyly with malalignment of the flexor pollicis longus tendon: a case report Dear Editor, Radial polydactyly with a floating-type thumb duplicate is usually treated with simple excision of the pedunculated digit. More recent reports have suggested that interphalangeal (IP) joint deviations can occur in conjunction with these types of radial polydactyly, a deformity that can persist or worsen after excision surgery (Lourie et al, 1995;Saito et al, 2018). Most recently, Hanaka et al (2021) investigated the clinical features of 12 patients with floating type radial polydactyly and found that two of the 12 thumbs showed a deviation at the IP joint preoperatively, which did not improve postoperatively.…”

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confidence: 99%

“…It is currently accepted that these deformities associated have a biomechanical basis; for example, the zigzag morphology of a Wassel Type IV duplicated thumbs can be associated with the aberrant location of the FPL in combination with the lack of the normal A1 pulley system (He et al, 2017). Lourie et al (1995) reported a case of marked IP joint radial deviation after suture ligature of a soft tissue tag at birth. They suggested that there might be a similarity in the causative mechanisms between the floating type radial polydactyly with the zigzag deformity found in Type IV duplicated thumbs, because the duplication was at the metacarpophalangeal joint level as evidenced by a widened metacarpal head.…”

mentioning

confidence: 99%