Polydactyly
Introduction
Introduction to multi-finger malformation Polydactyly (polydactyly), also known as repeated fingers, refers to fingers other than normal fingers, finger phalanx, simple soft tissue components or metacarpal, etc., is the most common hand congenital malformation in the clinic, males are higher than females. The ratio of male to female is 3:2, the right hand is more than the left hand, the ratio is 2:1, the incidence of both hands is about 10%, and the incidence of thumb multi-finger is about 90% of the total. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: metacarpophalangeal joint dislocation
Cause
Multi-finger malformation
Genetic factors (55%)
Pathological studies have shown that they are mostly autosomal dominant and have intergenerational genetic phenomena. Congenital multi-finger and toe deformity are mostly unilateral, and bilateral involvement only accounts for about 10%. Some are also associated with malformations in other systems such as cardiovascular or urinary.
Environmental factors (30%)
Mothers in the early 4-8 weeks of pregnancy, embryonic limb buds are affected by viral infections, drugs, radiation and other environmental factors, resulting in deformity of the fingers and deformed, more common in the shape of the thumb, and mostly scattered, suggesting the disease It is related to environmental factors and has little to do with genetic factors.
Prevention
Multi-finger malformation prevention
Strengthen health care and nutrition during pregnancy, avoid respiratory infections during pregnancy, gastrointestinal infections, avoid rubella, measles, chickenpox, mumps and other viral infections, avoid exposure to radiation, drugs and other possible teratogenic factors.
Complication
Multiple finger malformation complications Complications of the metacarpophalangeal joint
Associated with cardiovascular, neurological or urinary system malformations.
Symptom
Multi-finger malformation symptoms Common symptoms Hockey sticks multi-finger (toe) deformity Osteophytes a lot of hyperplasia can not bend the wrist to the ulnar side...
Classification: Multi-finger malformation is mainly divided into three types according to its occurrence and anatomy: thumb multi-finger type (also known as unilateral multi-finger, multi-finger front, complex thumb deformity), central multi-finger and posterior type The little finger of the little finger (also known as the multi-finger on the ulnar side, the multi-finger behind the axis), the classification of the thumb multi-finger, the Wassel classification method based on the abnormality of the pathological anatomical shape is currently used, which is divided into seven types, namely the last type finger type. There are three types of proximal phalanges and metacarpal types. Each type of deformity is divided into two types: a bifurcated bifurcation type and an articulated double-finger type according to the degree of separation of the repeated fingers. A total of 7 types, of which type IV is the most, accounting for 47%, type VII is 23%, type II is 15%, this classification is concise and concise, in line with pathological and anatomical rules, the classification of pinky and multi-finger is mostly Stelling-Twrek classification The method is divided into three types: type I is a twin finger, type II is a part of a bone structure, type III is a complete multi-finger including the metacarpal bone, and central multi-finger is rare. It is a repeat of the index finger, the middle finger and the ring finger. Malformation, the above three fingers are rarely single-finger complex finger deformities, but always contain complex fingers Shape, the most common multi-finger is hidden in the middle finger and the ring finger and middle finger deformity.
Examine
Multi-finger malformation
X-ray examination to understand the bones and joints of multiple fingers. Clinically, according to the tissue components contained in the twins, it can be divided into three categories: 1 soft tissue multi-finger: multi-finger only soft tissue neoplasm without bone tendon and other tissues; 2 simple multi-finger: multi-finger contains phalangeal tendon and vascular nerve The bundle is connected to a normal finger as a functionally defective finger; 3Complex multi-finger: Multi-finger is a true repetition that contains not only the phalanges, but also the metacarpal.
Diagnosis
Multi-finger malformation diagnosis
Multi-finger malformation is clear at a glance, most of which can be found and diagnosed during childbirth. In the repetitive phenomenon of tissue, including multi-fingery and mirror-handedness, in multi-finger malformation, the fingers of multiple births can be single or multiple, or multiple fingers on both sides; Multi-finger malformation is divided into unilateral multi-finger, central multi-finger and ulnar multi-finger three types, with the most common side of the unilateral side, followed by the ulnar side of multiple fingers, while the central multi-finger is rare, more fingers can be Occurs in the distal end of the finger, the proximal phalanx, connected to the normal phalanx or metacarpal bone, can also occur in the metacarpophalangeal joint, one side of the interphalangeal joint, and some of the multiple fingers can be the result of repeated development of a certain finger, there is a corresponding metacarpal bone Health, forming one hand and six fingers, even heavy hand deformity, but less common, multi-finger shape and structure are very different, can only be Pitty connected to the skin to a full finger, even difficult to distinguish between normal and multi-finger, As a result, the surgery determines the difficulty in staying. The angle of growth refers to different angles. Some of the fingers are at right angles to the temporal or ulnar side of the hand. Multi-finger deformities can exist alone or simultaneously with the deformity of the fingers. Exist, such as complex thumb deformity; also Excessive 3 or 4 fingers, forming a "mirror hand" deformity, ulnar side multi-finger can be accompanied by a variety of other malformations, such as the fingers, three phalanx thumb, spinal deformity, nail dysplasia, etc. It refers to deformity, bilateral is more common, named as multi-finger and refers to, central multi-finger and refers to a type of split hand deformity, X-ray examination of multiple fingers, clear bone and joint conditions, provide a basis for surgery . Congenital multi-finger and toe deformity can be clearly diagnosed according to medical history and clinical physical examination. The auxiliary examination is mainly to determine the type of multi-finger, toe and bone joint growth of X-ray film, and provide evidence for the choice of treatment plan. Cases, spiral CT examination, three-dimensional reconstruction, and further definition of the type and extent of deformity.
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