A novel revision technique in the treatment for postoperative deviation after radial polydactyly reconstruction

Postoperative deviation (PD) is a complicated and troublesome complication after polydactyly reconstruction. We aim to investigate the clinical efficacy of a novel revision surgery, reconstruction of the balance of bone and soft tissue, treating PD after radial polydactyly reconstruction in comparison with a previous surgical plan.

We reconstructed the balance of bone and soft tissue to correct PD and the asymmetrical appearance of the thumb. At the follow-up, we used the digital circumferential ratio (reconstructive/healthy side), Vancouver Scar Scale (VSS) score, Japanese Society for Surgery of the Hand (JSSH), aesthetic scoring system (ASS) modified Tada score and range of motion (ROM) to evaluate the appearance and function outcomes.

Seventeen PD patients received our new surgical plan (NG), and 31 patients received the traditional surgical plan (CG). There was no significant difference in gender, age, site of hand and follow-up period, as well as preoperative digital circumference ratio, deviation angle of metacarpophalangeal joints (MP) and interphalangeal joint (IP). At the final follow-up, we found that digital circumference ratio, JSSH and ASS were obviously higher in NG than in CG, implying that our novel surgical plan can provide good aesthetics and excellent postoperative function.

The reconstructive balance of bone and soft tissue can effectively improve the appearance and function of PD after polydactyly reconstruction. Mastering the indications for surgery and good microsurgical techniques are the keys to ensuring therapeutic effects.