Objective: To investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children.
Methods: Seven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3.1 years. The thumb-polydactyly was diagnosed with MRI and it was seen that the base of radial multi-finger and the proximal phalangeal joint were connected by cartilage. All patients were treated with resection, lateral collateral ligament reconstruction, bone osteotomy and internal fixation.
Results: The operation was successfully completed, and there was no early complications such as infection and flap necrosis. All patients were followed up 6-23 months (mean, 14.1 months). At last follow-up, there was no deformity finger, scar contracture, and other complications. The extension of the interphalangeal joint was no limited, and the flexion range of the interphalangeal joint was 20-75° (mean, 56.7°). The appearance and function of the thumb was rated as excellent in 3 cases and good in 4 cases by Japanese Society for Surgery of the Hand (JSSH) scoring, with the excellent and good rate of 100%.
Conclusion: The thumb polydactyly with symphalangism in children can be combined with clinical manifestations, X-ray film, and MRI examination to diagnose, and can obtain satisfactory results through the reconstruction of lateral collateral ligament, bone osteotomy, and internal fixation.
目的: 探讨小儿指间关节融合型复拇畸形的诊断及治疗方法。
方法: 2013 年 1 月—2017 年 5 月，收治 7 例小儿指间关节融合型复拇畸形。男 5 例，女 2 例；年龄 10 个月～11 岁，平均 3.1 岁。左侧 4 例，右侧 3 例。患儿均经 MRI 检查确诊，可见桡侧多指基底与近节指骨关节面以软骨相连。行桡侧多指切除、侧副韧带止点重建、近节指骨截骨矫形内固定。
结果: 手术均顺利完成，术后无感染、皮瓣坏死等早期并发症发生。患儿均获随访，随访时间 6～23 个月，平均 14.1 个月。末次随访时，指体无偏斜、瘢痕挛缩等情况发生，指间关节背伸活动无受限，屈曲活动度为 20～75°，平均 56.7°。采用日本手外科协会（JSSH）评分评价重建拇指的外观及功能，获优 3 例、良 4 例，优良率 100%。
结论: 小儿指间关节融合型复拇畸形可结合临床表现、X 线片及 MRI 检查确诊，通过侧副韧带止点重建结合截骨内固定治疗可获得满意疗效。
Keywords: Thumb polydactyly with symphalangism; children; congenital malformation; internal fixation; ligament reconstruction.