Determining normal and abnormal reference values for corrective osteotomy for congenital hand malformation: a study
Ahmad Zaki Barati1, Anyuan Wang1, Ismail Muhammad1
1Department of Hand and Plastic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
Insights
This study establishes normal thumb bone axis reference values for children, aiding corrective osteotomies in congenital hand malformations and polydactyly. Accurate preoperative planning using these values improves surgical outcomes.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Hand surgery
Background:
- Congenital hand malformations require precise surgical correction.
- Assessing bone alignment is crucial for effective osteotomy procedures in children.
- Establishing normal reference values aids in evaluating deviations and planning treatments.
Purpose of the Study:
- To establish normal reference values for the pediatric thumb bone axis.
- To assess the effectiveness of corrective osteotomy procedures.
- To guide treatment for congenital hand malformations and post-operative axis deviations.
Main Methods:
- Retrospective study of 192 individuals (January 2022 - October 2024).
- Measurement of bone axis angles in the metacarpal, proximal, and distal phalanges of the thumb.
- Comparison of normal reference values with those from patients with polydactyly types II and IV.
Main Results:
- Established comprehensive reference values for the normal thumb bone axis.
- Identified axis deviation in polydactyly type IV, correlating with surgical planning needs.
- Highlighted the importance of preoperative design for thumb reconstruction and potential for intraoperative site selection.
Conclusions:
- Reference values for thumb bone alignment significantly aid corrective osteotomy planning.
- These values enable surgeons to predict necessary osteotomy degrees, enhancing surgical results.
- Improved preoperative assessment leads to better postoperative outcomes and patient satisfaction.
Purpose:
This study aims to establish reference values for the normal bone axis in children to assess the effectiveness of corrective osteotomy procedures and guide the treatment of congenital hand malformations and post-operative axis deviations.
Methods:
A retrospective study was carried out between January 1, 2022, and October 9, 2024. A total of 192 individuals were included. In both abnormal and normal individuals, we measured the angles within the zone of provisional calcification and the bone axis. The metacarpal, proximal, and distal phalanx of the thumb were measured in both males and females. We calculated the average and standard deviations for both groups. These normal reference values were then compared with the abnormal reference values of patients who had types II and IV polydactyly.
Results:
Our work effectively established thorough reference values for the thumb's normal axis. Considering the success of corrective osteotomies in children with congenital deformities depends mostly on these values. In polydactyly type IV, we observed a change in the angle on the side with the axis deviation. Our results highlight the need for an exact preoperative design for thumb reconstruction. It also implies the possibility of choosing the side with little or no axis deviation during operation. This strategic selection can help prevent the need for additional osteotomies or subsequent surgeries.
Conclusion:
Evaluating and preparing corrective osteotomy treatments benefits significantly from the reference values for the proper alignment of the thumb's bones. These results enable surgeons to predict the degree of corrective osteotomy needed, thereby improving postoperative surgical results and patient satisfaction.
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