scholarly journals Surgical reconstruction in Wassel type IV thumb duplication

2014 ◽  
Vol 48 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Murat KAYALAR
Keyword(s):  
Surgical Reconstruction ◽  
Type Iv ◽  
Thumb Duplication

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication

2019 ◽  
Vol 52 (02) ◽  
pp. 147-150
Author(s):  
Kun Wang ◽  
Fangxin Ai ◽  
Pan Zhou ◽  
Zhiwei Liu ◽  
Zhenbing Chen ◽  
...  
Keyword(s):  
Metacarpophalangeal Joint ◽  
Suture Technique ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Type Iv ◽  
Pull Out ◽  
Thumb Duplication ◽  
The Right ◽  
Pull Out Suture

Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.

Type IV Acromioclavicular Joint Separation in a Collegiate Basketball Player

2016 ◽  
Vol 21 (6) ◽  
pp. 16-20
Author(s):  
Gail M. Ronchetti ◽  
Christopher A. Welch ◽  
Brent I. Smith ◽  
Danielle E. Blair
Keyword(s):  
Return To Play ◽  
Surgical Reconstruction ◽  
Basketball Player ◽  
Shoulder Injury ◽  
Unique Type ◽  
Type Iv ◽  
Successful Recovery ◽  
Slow Progression ◽  
Acromioclavicular Separation ◽  
Joint Separation

A 19-year-old female basketball athlete sustained a right shoulder injury during collegiate competition resulting from a collision causing severe pain and discomfort. The patient was diagnosed with a unique type IV acromioclavicular (AC) separation. Surgical stabilization of the AC joint and slow progression in rehabilitation with immobilization assisted in protecting the reconstruction. Accurate diagnosis and appropriate intervention helped to lead to the successful recovery and return to play for this patient. There are few cases of type IV acromioclavicular separation reported in the literature and none related to basketball. This case presents the challenges related to the diagnosis and rehabilitation following surgical reconstruction of a type IV acromioclavicular separation.

Causes of secondary deformity after surgery to correct Wassel type IV-D thumb duplication

2016 ◽  
Vol 41 (7) ◽  
pp. 739-744 ◽  
Author(s):  
B. He ◽  
G. Nan
Keyword(s):  
Kirschner Wire ◽  
Incomplete Resection ◽  
Flexor Pollicis Longus ◽  
Level Of Evidence ◽  
Thenar Muscle ◽  
Type Iv ◽  
Kirschner Wire Fixation ◽  
Thumb Duplication ◽  
Secondary Deformity ◽  
A2 Pulley

This study was undertaken to document the causes of secondary deformities after surgery for correction of Wassel type IV-D thumb duplication. We carefully dissected and observed the flexor pollicis longus, and bone and joint anatomy in eight patients with secondary deformities after surgical correction. We transferred the flexor pollicis longus and thenar muscle attachments, reconstructed the A2 pulley, released and tightened the joint capsule, and performed osteotomies to correct skeletal malalignment. Kirschner wire fixation was used for 4–5 weeks, followed by brace fixation for 3 months. Patients were followed up for 13–34 months (mean 20 months). According to the Tada scores, the outcomes were good in six patients, and fair and poor in one patient each. The main causes of the secondary deformities were failure to reconstruct the A2 pulley, to transfer the flexor pollicis longus and thenar muscles, and incomplete resection of the radial metacarpal head. Brace fixation after Kirschner wire removal is crucial in preventing secondary deformities. Level of evidence: IV

scholarly journals Type IV-D thumb duplication: A new reconstruction method

2010 ◽  
Vol 96 (5) ◽  
pp. 521-524 ◽  
Author(s):  
A. Abid ◽  
F. Accadbled ◽  
G. Knorr ◽  
P. Darodes ◽  
J.-P. Cahuzac ◽  
...  
Keyword(s):  
Reconstruction Method ◽  
Type Iv ◽  
Thumb Duplication

The distribution of the types of thumb polydactyly in a middle eastern population: a study of 228 hands

2009 ◽  
Vol 35 (3) ◽  
pp. 182-187 ◽  
Author(s):  
M. M. Al-Qattan
Keyword(s):  
Middle Eastern ◽  
Far East ◽  
Type I ◽  
Type Iv ◽  
The Far East ◽  
Thumb Duplication ◽  
Middle Eastern Population ◽  
Genetic Pools ◽  
Almost All ◽  
Far Eastern

Several series have reported the distribution of the types of thumb polydactyly in the Caucasian and Far Eastern populations. No data are available for the Middle East. A total of 196 Saudi patients (228 hands) with thumb polydactyly were reviewed. The most common type was Wassel type IV (33.8%) and the least common was Wassel type I (0.4%). A total of 26 hands (11.4%) did not fit into the classic Wassel types including 18 cases of rudimentary duplications, two cases of thumb triplication, and five cases of thumb duplication with symphalangism. Concurrent ipsilateral little finger triplication (one case) and contralateral thumb aplasia/hypoplasia (two cases) were seen and the developmental biology of these cases are discussed. After reviewing our results and other series in the literature, we concluded that Wassel types IV and I remain to be the most and least common types respectively in almost all races. However, the genetic pools of various races greatly affect the distribution of other non-classic duplications (unclassifiable by Wassel classification) such as rudimentary duplication in the Far East, triplication in the Southwestern region of the Netherlands, and symphalangism in Asia.

Preoperative percutaneous arthrography provides detailed information for treatment of Wassel type IV thumb duplication

2018 ◽  
Vol 71 (12) ◽  
pp. 1717-1722 ◽  
Author(s):  
Qianqian Liu ◽  
Lei Zhong ◽  
Hong Li ◽  
Jun Liu ◽  
Zhe Zhu ◽  
...  
Keyword(s):  
Type Iv ◽  
Thumb Duplication
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