Prognostic value of age and Wassel classification in the reconstruction of thumb duplication

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dc.contributor.authorCabrera G, M.
dc.contributor.authorPérez L, L. M.
dc.contributor.authorMartínez Soto, Gino Rolando
dc.contributor.authorGutiérrez de la I, D.
dc.date.accessioned2020-01-14T01:06:51Z
dc.date.available2020-01-14T01:06:51Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Various surgical techniques for thumb duplication have been described. The main goal in thumb reconstruction is to achieve optimal function, stability, and shape. Few publications have quantified the functional results of each surgical option and factors that may affect these outcomes. METHODS: We performed a retrospective review during the period from 1990 to 2011 of 115 surgery patients, 99 of whom had a mean postoperative follow-up of 44.1 months. They were classified according to the Wassel classification. We assessed the surgical technique, functional results, and complications, and evaluated the probable prognostic value of age and Wassel classification. RESULTS: This case series comprised mainly female patients (62 %) and the right hand (74 %), with a mean age at operation of 20 months. The most common group was Wassel type IV (54 %). On the basis of the Tada scoring system, we obtained 91 good results (91 %). Complications occurred in 27 patients (27 %), mainly instability and axis deformation. In a comparison of preoperative factors (age at the time of surgery and Wassel classification) with the final results (Tada score and complications), the association between older age at surgery and complications (p = 0.0001) and Wassel types III and IV and complications (p = 0.0210 and p = 0.0095) was statistically significant. CONCLUSIONS: Following the basic concepts of anatomical reconstruction, we obtained good results in most patients. The main complications were instability and axial deformity. These were most common in patients who underwent operations at an age of more than 12 months, and patients with Wassel types III and IV deformities. BACKGROUND: Various surgical techniques for thumb duplication have been described. The main goal in thumb reconstruction is to achieve optimal function, stability, and shape. Few publications have quantified the functional results of each surgical option and factors that may affect these outcomes. METHODS: We performed a retrospective review during the period from 1990 to 2011 of 115 surgery patients, 99 of whom had a mean postoperative follow-up of 44.1 months. They were classified according to the Wassel classification. We assessed the surgical technique, functional results, and complications, and evaluated the probable prognostic value of age and Wassel classification. RESULTS: This case series comprised mainly female patients (62 %) and the right hand (74 %), with a mean age at operation of 20 months. The most common group was Wassel type IV (54 %). On the basis of the Tada scoring system, we obtained 91 good results (91 %). Complications occurred in 27 patients (27 %), mainly instability and axis deformation. In a comparison of preoperative factors (age at the time of surgery and Wassel classification) with the final results (Tada score and complications), the association between older age at surgery and complications (p = 0.0001) and Wassel types III and IV and complications (p = 0.0210 and p = 0.0095) was statistically significant. CONCLUSIONS: Following the basic concepts of anatomical reconstruction, we obtained good results in most patients. The main complications were instability and axial deformity. These were most common in patients who underwent operations at an age of more than 12 months, and patients with Wassel types III and IV deformities.
dc.format.extent6 páginas
dc.fuente.origenFacultad de Medicina
dc.identifier.doi10.1007/s11832-013-0534-3
dc.identifier.issn1863-2521
dc.identifier.urihttps://doi.org/10.1007/s11832-013-0534-3
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/27445
dc.issue.numeroNo. 6
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final557
dc.pagina.inicio551
dc.revistaJournal of Children's Orthopaedicses_ES
dc.rightsacceso abierto
dc.subjectHand reconstructive surgeryes_ES
dc.subjectPolydactylyes_ES
dc.subjectPrognostic valuees_ES
dc.subjectTada scorees_ES
dc.subjectThumb duplicationes_ES
dc.subjectWassel classificationes_ES
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titlePrognostic value of age and Wassel classification in the reconstruction of thumb duplicationes_ES
dc.typeartículo
dc.volumenVol. 7
sipa.codpersvinculados123128
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