Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10909
Peer-review started: July 11, 2021
First decision: August 18, 2021
Revised: August 22, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: December 16, 2021
Processing time: 151 Days and 21.3 Hours
Thumb polydactyly is one of the most common congenital hand deformities, and the Bilhaut-Cloquet procedure or a modified one is often used. However, controversy remains over the rare instances in which both thumbs are not of similar length or far apart in distance.
Bilhaut-Cloquet procedure or a modified one is often used for thumb polydactyly. However, controversy remains over the rare instances in which both thumbs are not of similar length or far apart in distance.
To evaluate the clinical outcomes of pedicle complex tissue flap transfer in the treatment of duplicated thumbs with unequal size.
We performed a cross-sectional study of patients who underwent duplicated thumb reconstruction by pedicle complex tissue flap transfer from January 2014 to December 2020.
An appropriate volume with a stable joint and good appearance was obtained in 14 reconstructed thumbs. The mean ALURRA score was 21.8 (range: 20-24), and the Tada score was 6.9 (range: 5-8). Compared with the non-operated side, the length of the operated thumb was approximately 95%, the girth was 89%, and the nail width was 82.9%. The mean ranges of motion were 62.1% of that of the unaffected thumb in the interphalangeal joint and 78.3% in the metacarpophalangeal joint.
Harvesting a pedicle flap from a severed thumb is a safe and reliable procedure. Defects of the preserved thumb, such as the skin, nail, and bone, can be effectively restored using the complex tissue flap.
Pedicle complex tissue flap transfer should be the initial management strategy for patients with duplicated thumbs with unequal size. In the future, more controlled studies with multicenter samples will be needed to confirm this finding.