The purpose of this study is to evaluate the functional and aesthetic outcomes in children with Wassel IV thumb duplication
Wassel IV thumb duplication is a congenital hand anomaly characterized by the presence of two adjacent thumbs. This condition has significant functional and aesthetic implications. Previous studies have highlighted the complexity of the surgical management of Wassel IV thumb duplication, underscoring the need for an individualized approach for each case. Early interventions are often recommended to optimize long-term functional and aesthetic outcomes. The field of study for evaluating these outcomes focuses on the analysis of the medium and long-term consequences of surgical interventions in children with this malformation. Evaluation criteria may include hand functionality, thumb mobility, overall aesthetics, and other aspects relevant to the quality of life of the affected pediatric patients. This medium and long-term approach offers crucial insights for refining treatment protocols and improving the overall management of this condition.
Study Type
OBSERVATIONAL
Enrollment
30
This intervention involves the surgical correction of Wassel IV thumb duplication, which is a congenital hand anomaly. The study retrospectively evaluates the outcomes of various surgical techniques that have been employed to correct this condition, with a focus on functionality and aesthetics of the thumb post-surgery. Data collected post-intervention include preoperative metacarpophalangeal angle, type of skin flap, surgical reconstruction technique, immobilization method, and postoperative complications. Additionally, patient satisfaction and daily pain levels are assessed using standardized questionnaires. Each patient serves as their own control, with outcomes compared to their contralateral healthy thumb.
Functional and Aesthetic Outcomes
Evaluation of functional and aesthetic outcomes using the Japanese Society for Surgery of the Hand (JSSH) scoring method. Functional outcomes include thumb mobility and function scored out of 10 points, and aesthetic outcomes include overall thumb appearance scored out of 14 points. The minimal and worst score is 0, the maximal and best score is 30.
Time frame: Up to one year post-surgery for the primary outcome measure time frame
Comparison of Surgical Techniques
Evaluate which surgical reconstruction techniques yield better functional and aesthetic outcomes. Soft tissue reconstruction only or need for osteotomy.
Time frame: One year post-operative, to align with the follow-up period of the primary outcome measure.
Efficacy of Skin Flap Types
Assess the outcomes associated with different types of skin flaps used in the surgical correction. Number of "racquet skin plasty" and number of "Dautel flap". The evaluation of skin flaps will be assessed by various measures: the circumference of the thumb in millimeters, the appearance of the scar by self-assessment (visual analogue scale), and the symmetry of the thumb by self-assessment (visual analogue scale). All these measures are integrated into the JSSH score.
Time frame: One year post-operative, to align with the follow-up period of the primary outcome measure.
Immobilization Method Analysis
Determine the effectiveness of various immobilization methods post-surgery. Plaster immobilization or splint, with or without wire.
Time frame: One year post-operative, to align with the follow-up period of the primary outcome measure.
Preoperative Angle Decision Model
Measurement of the preoperative metacarpophalangeal angle of the thumb to be reconstructed. Develop a decision-making model for surgery based on the preoperative radiographic metacarpophalangeal angle.
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Time frame: One year post-operative, to align with the follow-up period of the primary outcome measure.