Central polydactyly--a review of 12 cases and their surgical treatment.
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Biomedical subjects
Publications and source records attributed to Y Tsuyuguchi.
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Surgical procedures and the results of reconstruction of the mirror hand anomaly are presented. The thumb was reconstructed by pollicization of the radial third finger and multiple muscle transfer. The function of wrist, forearm, and elbow improved with arthroplasty of the affected joints. The results of the follow-up are satisfactory. We believe that surgical treatment of the mirror hand should be started in early life.
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A total of 523 Japanese patients with terminal limb congenital malformations were reviewed for the characteristic features, and especially for type correlation between hand and foot anomalies. There were 281 cases of hand involvement alone, 149 cases of foot involvement alone, and 93 cases of combined hand and foot involvement. Polydactyly was commonly preaxial in the hand and postaxial in the foot, in contrast to the well-known postaxial dominance in the hand among whites. Hand anomalies were likely to show the same Swanson type of anomaly as the foot, with the affected digital ray likely to be identical in both hand and foot.
We reviewed thirty-seven hands of 26 patients with radial ray deficiency. Twelve patients (46%) had associated anomalies in extremities and/or other systems. Following Blauth's method, we classified patients into five groups. There was a positive correlation between the severity of the dysplasia of the thumb and the radius. Twelve hands of 10 patients were surgically treated. The mean follow-up time was 45 months. Only six hands had satisfactory cosmesis and function after surgery. We discuss the difficulty of treatment for severe cases.