Document Detail

Duplicated thumb bifurcation at the metacarpophalangeal joint level: factors affecting surgical outcome.
MedLine Citation:
PMID:  9260625     Owner:  NLM     Status:  MEDLINE    
In order that the factors causing poor surgical outcome might be clarified, 175 duplicated thumbs bifurcating at the metacarpophalangeal joint level were analyzed. Cases were further divided into types A-D, based upon the details of the bifurcation form; that is, based on the connection of the radial digit to the ulnar components by either cartilage, joint, or fibrous tissue. The incidence of each type was 16% for type A (wide cartilaginous connection between phalanges), 68% for type B (2 separate phalanges), 6% for type C (cartilaginous connection to metacarpal), and 10% for type D (fibrous connection to joint capsule). Triphalangeal types and the relative size of the excised digit were determined by the preoperative radiograph. One hundred six cases were available for evaluation with a minimum of 3 years' follow-up. Good results were obtained in 50% of types A and C and in 80% of types B and D. Three phalanges in the preserve digits were observed in 10 cases and surgery on all but 1 resulted in a fair outcome. In cases where the size of the excised digit was more than 75% of the preserved digit, the results were fair or pool in 93%. The presence of subdivisions of types A and C, of 3 phalanges in the preserved digit, and of a relatively bigger excised digit were factors causing poor results, despite intensive reconstructive surgery.
E Horii; R Nakamura; M Sakuma; T Miura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  22     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-10-09     Completed Date:  1997-10-09     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  671-9     Citation Subset:  IM    
Department of Orthopedics, Nagoya University, Japan.
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MeSH Terms
Child, Preschool
Follow-Up Studies
Hand Deformities, Congenital / radiography,  surgery*
Metacarpophalangeal Joint / abnormalities,  radiography,  surgery*
Thumb / abnormalities*,  radiography,  surgery*
Treatment Outcome

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