Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10909-10918
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10909
Pedicle complex tissue flap transfer for reconstruction of duplicated thumbs with unequal size
De-Hua Wang, Gui-Ping Zhang, Zeng-Tao Wang, Meng Wang, Qin-Yi Han, Fan-Xiao Liu
De-Hua Wang, Zeng-Tao Wang, Meng Wang, Department of Hand and Foot, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Gui-Ping Zhang, Department of Anesthesiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, Shandong Province, China
Qin-Yi Han, Department of Hand and Foot, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
Fan-Xiao Liu, Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Author contributions: Liu FX, Wang DH, and Han QY designed the research study; Wang DH, Zhang GP, Wang ZT, Wang M, Han Q, and Liu FX performed the research; Liu FX and Han QY analyzed the data; Wang DH, Zhang GP, Wang ZT, Wang M, Han QY, and Liu FX wrote the manuscript; Liu FX and Han QY contributed equally in the planning, construction, and writing of the manuscript.
Supported by the China Scholarship Council, No. 201808080126 (to Liu FX).
Institutional review board statement: The study was reviewed and approved by the Biomedical Ethic Committee of Shandong Provincial Hospital (Approval No. 2021-018).
Informed consent statement: Written consent was obtained from the patients’ parents for the purpose of publication of case details and images.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qin-Yi Han, MD, Doctor, Department of Hand and Foot, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Qingwuweiqi, Jinan 250021, Shandong Province, China. hanqinyi@126.com
Received: July 11, 2021
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To evaluate the clinical outcomes of pedicle complex tissue flap transfer in the treatment of duplicated thumbs with unequal size.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.