KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ DỊ TẬT HAI NGÓN TAY CÁI ĐỘ IV THEO PHÂN LOẠI WASSEL Ở TRẺ EM TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objective: To contribute to the study of clinical characteristics and surgical outcomes in the treatment of Wassel type IV prexial polydactyly in children. Subjects and Methods: This retrospective and prospective study included pediatric patients diagnosed with Wassel type IV prexial polydactyly who underwent surgical treatment at Viet Duc University Hospital between January 2021 and December 2024. Results: A total of 67 patients underwent surgery during the study period. The mean age was 4.1 ± 4.0 years. The male-to-female ratio was approximately 2:1, with the right hand being more commonly affected (53.7%). In 98.7% of cases, the radial duplicated thumb was excised; one case (1.3%) was treated using the Bilhaut–Cloquet procedure. The outcomes were classified as good in 35.1%, fair in 63.6%, and poor in 1.3% after an average follow-up period of 22.4 ± 9.2 months. The mean hospital stay was 2.5 ± 0.9 days. Surgical correction significantly improved thumb alignment and opposition, with the score increasing from 7.2 to 7.8. The most common complications were angular deformities, observed in 41.6% at the metacarpophalangeal (MP) joint and 35.1% at the interphalangeal (IP) joint. Other complications included prominence of the metacarpal head (45.5%) and MP joint instability (22.1%). Conclusion: Early surgery (around 1 year) is recommended, with emphasis on collateral ligament reconstruction and abductor pollicis brevis tendon transfer. Long-term follow-up is essential to monitor for late complications.