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An unusual manifestation of asymmetric polydactyly of both feet and symmetrical polydactyly of both hands. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2023; 45:25-28. [PMID: 36522467 DOI: 10.1007/s00276-022-03062-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
In the routine treatment at the hospital, it was observed that a 31-year-old Asian woman developed foot pain after work, with clinical manifestations including local tenderness, abrasion, and a rare case of polydactyly with bilateral foot asymmetry. In addition, we also found that the patient had two-handed symmetric polydactyly. According to our observations, there seem to be few similar cases reported in the past of a two-handed symmetric polydactyly combined with a feet asymmetry polydactyly in the same person, so this is a relatively rare reported case of polydactyly. This paper aims to present detailed case report and discuss related diseases in a morphological and clinical study.
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Lee JY, Liu Xuan E, Chew EM, Yeo NEM. Polymetatarsia of the Foot without Polydactyly: A Case Report. JBJS Case Connect 2021; 11:01709767-202112000-00005. [PMID: 34613951 DOI: 10.2106/jbjs.cc.21.00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report a rare case of polymetatarsia without polydactyly. Our patient presented with pain and difficulty with shoewear. Radiographs showed an accessory metatarsal arising from the lateral aspect of the fourth metatarsal proximal metaphysis, fusing distally with the medial aspect of the fifth metatarsal head to form a single metatarsophalangeal joint. He was treated with a chevron osteotomy of the conjoined complex and an Akins osteotomy of the fifth proximal phalanx. Our patient recovered functionally, and his pain improved postoperatively. CONCLUSION The chevron osteotomy is an option for treating polymetatarsia without polydactyly with the aim of reducing the forefoot width. LEVEL OF EVIDENCE Case study, level 5.
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Affiliation(s)
- Jia Ying Lee
- Department of Orthopedic Surgery, Singapore General Hospital, Singapore
| | - Eric Liu Xuan
- Department of Orthopedic Surgery, Singapore General Hospital, Singapore
| | - Ee Ming Chew
- Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore
| | - Nicholas Eng Meng Yeo
- Department of Orthopedic Surgery, Singapore General Hospital, Singapore.,Director of Foot and Ankle Service, Singapore General Hospital, Singapore
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Kurokawa T, Iba K, Hanaka M, Teramoto A, Emori M, Hayakawa H, Saito A, Takashima K, Yamashita T. Surgical Procedures Based on the Arthrographic Findings of the Fifth MTP Joint With Proximal Phalanx Duplication in Postaxial Polydactyly of the Foot. J Foot Ankle Surg 2021; 60:983-989. [PMID: 34006434 DOI: 10.1053/j.jfas.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 02/03/2023]
Abstract
Radiographic findings in several atypical cases of postaxial polydactyly of the foot do not provide sufficient information to assess the cartilaginous structures or duplicated digit connections at the MTP joint. The purpose of this study was to demonstrate the surgical procedures using arthrography for the cartilaginous structures of the MTP joint in postaxial polydactyly of the foot. We performed arthrography in 7 feet of 7 patients with postaxial polydactyly of the foot in which duplication of the proximal phalanx was observed at the fifth MTP joint on the basis of radiographic evaluation. The average age at surgery was 13.5 months and average duration of postsurgical follow-up was 36 months. Individual surgical procedures were confirmed or modified during the operation by reference to the arthrographic findings. Radiographic and arthrographic findings were assessed in relation to the findings from direct observation of the cartilaginous structures at surgery. Postoperative malalignment, functional disturbance and pain in the reconstructed toe were evaluated. The arthrographic findings provided different forms of cartilaginous structures that could be categorized in 4 types, and reflected the cartilaginous connection visualized at surgery that could not be detected on radiographs in each case. No cases revealed any deformities, functional disturbance, or pain in the reconstructed toe after surgery. The parents' evaluation in each case was "very satisfied" or "satisfied." The arthrographic findings provided additional information regarding variations in the cartilaginous structures of the fifth MTP joint and for determining individual surgical procedure for postaxial polydactyly of the foot.
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Affiliation(s)
- Takafumi Kurokawa
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kousuke Iba
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Megumi Hanaka
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Makoto Emori
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hikaru Hayakawa
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akira Saito
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kenichi Takashima
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
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Bingol O, Ozdemir G, Arslantas E, Yasar NE. Reconstruction of Foot Postaxial Polydactyly Using the On-top Plasty: A Case Report. J Foot Ankle Surg 2021; 60:382-385. [PMID: 33353821 DOI: 10.1053/j.jfas.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/21/2020] [Accepted: 08/09/2020] [Indexed: 02/03/2023]
Abstract
Polydactyly is a common congenital hand, foot, or both anomalies characterized by the presence of extra fingers. Postaxial polydactyly is the most common congenital malformation consisting of the lateral or fibular aspect of the foot. Extra finger excision in the treatment of foot polydactyly is considered the basic procedure in surgery. However, in some cases more complex surgeries should be preferred. In this study, the "on-top plasty" method with a minimally invasive approach is presented in a case of complex foot postaxial polydactyly.
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Affiliation(s)
- Olgun Bingol
- Orthopaedic Surgeon, Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey.
| | - Guzelali Ozdemir
- Orthopaedic Surgeon, Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey; Associate Professor, Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey
| | - Emrah Arslantas
- Orthopaedic Surgeon, Boyabat State Hospital, Orthopaedics and Traumatology Clinic, Boyabat, Sinop, Turkey
| | - Niyazi Erdem Yasar
- Resident, Ankara City Hospital, Orthopaedics and Traumatology Clinic, Cankaya, Ankara, Turkey
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Youngberg R, Platt S. Variant metatarsal morphology causing metatarsal deformation in postaxial polydactyly. ANZ J Surg 2019; 89:E568-E569. [PMID: 30699465 DOI: 10.1111/ans.14987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 10/21/2018] [Accepted: 10/25/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Rhys Youngberg
- Department of Orthopaedic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Simon Platt
- Department of Orthopaedic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
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Chen G, Han Q, Liu H, Zhang H, Jiang Z, Feng N, Chang F. Accurate Osteotomy for the Treatment of a Rare Case of Postaxial Polydactyly of the Foot That Originated From a Deformed Calcaneus Using a 3D-Printed Guiding Plate. J Foot Ankle Surg 2019; 58:171-175. [PMID: 30448182 DOI: 10.1053/j.jfas.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Indexed: 02/03/2023]
Abstract
Polydactyly is a common congenital deformity of the foot that can be categorized as preaxial, central, or postaxial. Current treatments involve resecting the supernumerary toe(s) and repairing the normal toe(s) and soft tissue. Here, we present the first published report describing a very rare case of polydactyly of the foot, in which the supernumerary toe originated from a deformed calcaneus, which formed an abnormal bony bump. Preoperatively, 3-dimensional (3D) computed tomography reconstruction images revealed the morphology of the deformed toe and calcaneus, and gait analysis showed an abnormal weightbearing zone in the left foot. The 3D printing technology and a specially designed 3D-printed guiding plate were used for osteotomy. Postoperatively, x-ray showed that the calcaneus had a normal shape and surface, whereas gait analysis showed that the left foot was uniformly loaded and the area of pain was eliminated. Our findings should raise awareness among clinicians that a 3D-printed guiding plate is useful in the treatment of such an unusual deformity.
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Affiliation(s)
- Gaoyang Chen
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Qing Han
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - He Liu
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Hanyang Zhang
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Zhende Jiang
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Naibo Feng
- Clinical Fellow, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China
| | - Fei Chang
- Chief, Foot and Ankle Surgery, Department of Orthopaedic Surgery, Second Hospital of Jilin University, Changchun, China.
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Escudero MI, Seebach K, Parekh SG, Pellegrini MJ. Treatment of postaxial polydactyly with plantar plate and medial collateral ligament reconstruction after supernumerary excision: A case report. SAGE Open Med Case Rep 2017; 5:2050313X17737197. [PMID: 29085641 PMCID: PMC5648087 DOI: 10.1177/2050313x17737197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/25/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction: Polydactyly is the most common congenital foot anomaly and consists of partial or complete duplication of a toe. Traditionally, surgical treatment has been amputation. There is little evidence when surgical treatment requires repairing the stabilizing structures of the metatarsophalangeal joint Objective: Assess the functional and radiologic outcomes of a case of postaxial polydactyly requiring plantar plate plate and medial collateral ligament reconstruction. Methods: A 59-year-old female presented at clinic complaining from bilateral fifth toe polydactyly and metatarsalgia. A rudimentary extra toe with bony structures poorly developed was observed in the left foot. An excision was performed on the left foot. In the right foot, a fully developed extra digit was observed with medial and downwards deviation underneath the fourth metatarsal. Results: Medial fifth-toe excision, plantar plate repair and medial collateral ligament reconstruction were performed due to malformation and widening of the distal surface of the plantar plate. Patient satisfaction and adequate functional status were observed at one-year follow-up. Conclusion: The plantar plate is the principal stabilizer of the MTP joint; therefore its reconstruction is of paramount importance for forefoot biomechanics.
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Affiliation(s)
- Mario I Escudero
- Department of Orthopedics, Hospital Clinico, University of Chile, Santiago, Chile
| | - Klaus Seebach
- Department of Orthopedics, Hospital Clinico, University of Chile, Santiago, Chile
| | - Selene G Parekh
- Department of Orthopaedic Surgery, North Carolina Orthopaedic Clinic, Durham, NC, USA.,Duke Fuqua School of Business, Durham, NC, USA
| | - Manuel J Pellegrini
- Department of Orthopedics, Hospital Clinico, University of Chile, Santiago, Chile
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