Modified method for reconstruction of thumb abduction function in children undergoing surgical treatment of thumb duplication

Abstract

Purpose This study was performed to evaluate a modified method of reconstructing the thumb abduction function in children undergoing surgical treatment of thumb duplication. Methods This retrospective study included 33 children (38 thumbs) with Wassel type III to VII thumb duplication who underwent excision of the polydactylism and osteotomy of the preserved thumb. Among them, 16 children (19 thumbs) underwent reconstruction of the attachment of the articular capsule and collateral ligament of the metacarpophalangeal joint, abductor pollicis brevis and flexor pollicis brevis by the anchor technique (Group A), while 17 children (19 thumbs) underwent suturing the attachment of the above-mentioned soft tissues to the periosteum (Group B). All children were followed up for six years after surgery. The appearance, function and joint stability of the preserved thumb were compared between the two groups; the bone alignment and development were observed. Results The deformity rate of preserved thumbs and the positive rate of lateral stress test were significantly lower in Group A than B (p < 0.05). The modified Tada score and the distance of first web were significantly higher in Group A than B (p < 0.05). Flexion, extension, adduction, abduction and palmar movement of the thumbs were good; bone alignment and development were good and no osteophyte or anchor shadow was left in the preserved thumbs in Group A. Conclusion Reconstruction of the abduction function using the anchor technique is effective in children undergoing surgical treatment for Wassel type III to VII thumb duplication and it may be superior to the conventional technique. Level of evidence III