Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Congenital Postaxial Polydactyly of the Foot Using Magnetic Resonance Imagings

족부에 발생한 선천성 축후성 다지증에 대한 자기공명영상 검사 결과 분석

  • Woo, Sang Hyun (W Institute for Congenital Limb Deformity, W Hospital) ;
  • Baek, Hyeon Seok (W Institute for Congenital Limb Deformity, W Hospital) ;
  • Kim, Young Kyu (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital) ;
  • Choi, Jun Young (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital)
  • 우상현 (W병원 선천성 사지변형센터) ;
  • 백현석 (W병원 선천성 사지변형센터) ;
  • 김영규 (인제대학교 일산백병원 정형외과) ;
  • 최준영 (인제대학교 일산백병원 정형외과)
  • Received : 2017.10.06
  • Accepted : 2018.02.07
  • Published : 2018.12.30
⟨ Previous Next ⟩

Abstract

Purpose: We aimed to evaluate the magnetic resonance imaging (MRI) findings of congenital postaxial polydactyly of the foot. Materials and Methods: Three-hundred and forty-seven feet of 288 patients who underwent congenital postaxial polydactyly or polysyndactyly correction were divided into five subtypes according to the radiographic shapes of deformity origins (widened metatarsal head, bifid, fused duplicated, incompletely duplicated, or completely duplicated). MRIs were assessed to determine whether they unrevealed areas were fused or separated. MRI was also used to assess cases with radiographic phalangeal aplasia. Results: Huge variations were noted in MRIs. Fusion or separation at the base or head between original and extra digits were observed, and MRI effectively depicted phalangeal aplastic areas. Conclusion: MRI evaluations of congenital postaxial polydactyly of the foot are useful for determining the anatomical statuses which were not visualized by plain radiography (level of evidence: 3).

목적: 족부에 발생한 선천성 축후성 다지증에 자기공명영상 검사를 실시하여 그 결과에 대해 평가하고자 한다. 대상 및 방법: 족부에 발생한 선천성 축후증 다지증 및 다지합지증으로 수술을 시행받은 347예(288명)에 대하여 단순 방사선 사진상에 나타나는 변형이 시작되는 부위에 따라 다섯 개의 군으로 분류하였다(넓은 중족골두, 이분중족, 유합된 복제, 불완전 복제, 완전복제 군). 골화가 이루어지지 않아 단순 방사선 사진상 나타나지 않는 부위에 대하여 자기공명영상 검사를 실시하여 유합 혹은 분리여부를 확인하였다. 또한 단순 방사선 사진상 지골 형성이 되지 않은 것처럼 보이는 부분에 대해서도 자기공명영상 검사를 실시하였다. 결과: 단순 방사선 사진상 골화가 이루어지지 않은 부분에 있어서 자기공명영상 검사를 실시하여 보니 잉여지와 고유지 간 유합 혹은 분리되는 양상이 다양하게 관찰되었다. 또한 지골 형성이 이루어지지 않은 듯 보이는 부분에 대해서도 지골의 상태를 효과적으로 알 수 있게 하였다. 결론: 족부에 발생한 선천성 축후성 다지증에 실시하는 자기공명영상 검사는 단순 방사선 사진에서 확인되지 않는 부분에 대한 정확한 해부학적 상태를 알려줄 수 있는 유용한 장치로 사용될 수 있다.

Keywords

References

  1. Miura T, Nakamura R, Imamura T. Polydactyly of the hands and feet. J Hand Surg Am. 1987;12:474-6. https://doi.org/10.1016/S0363-5023(87)80027-8
  2. Son WG, Kwon ST, Lee SW. Simple classification of foot polydactyly based on the status of metatarsal bone and varus deformity. J Korean Soc Plast Reconstr Surg. 2004;31:501-5.
  3. Nogami H. Polydactyly and polysyndactyly of the fifth toe. Clin Orthop. 1986;204:261-5.
  4. Venn-Watson EA. Problems in polydactyly of the foot. Orthop Clin North Am. 1976;7:909-27.
  5. Wassel HD. The results of surgery for polydactyly of the thumb. a review. Clin Orthop Relat Res. 1969;64:175-93.
  6. Lee HS, Park SS, Yoon JO, Kim JS, Youm YS. Classification of postaxial polydactyly of the foot. Foot Ankle Int. 2006;27:356-62. https://doi.org/10.1177/107110070602700507
  7. Seok HH, Park JU, Kwon ST. New classification of polydactyly of the foot on the basis of syndactylism, axis deviation, and metatarsal extent of extra digit. Arch Plast Surg. 2013;40:232-7. https://doi.org/10.5999/aps.2013.40.3.232
  8. Konno M, Hirase Y. A clinical review of polydactyly in the foot and postoperative results of lateral ray polydactyly. J Jpn Soc Plast Reconstr Surg. 1997;17:211-25.
  9. Watanabe H, Fujita S, Oka I. Polydactyly of the foot: an analysis of 265 cases and a morphological classification. Plast Reconstr Surg. 1992;89:856-77. https://doi.org/10.1097/00006534-199205000-00014
  10. Hefti F, Brunner R, Hasler CC, Jundt G. Pediatric orthopedics in practice. Heidelberg: Springer Medizin; 2007.
  11. Patel P. Pediatric foot and ankle. In: Parekh SG, ed. Foot and ankle surgery. New Delhi: Jaypee Brothers Medical Publishers; 2012. 468-9.
  12. Kawabata H, Tada K, Masada K, Kawai H, Ono K. Revision of residual deformities after operations for duplication of the thumb. J Bone Joint Surg Am. 1990;72:988-98. https://doi.org/10.2106/00004623-199072070-00005
  13. Phelps DA, Grogan DP. Polydactyly of the foot. J Pediatr Orthop. 1985;5:446-51. https://doi.org/10.1097/01241398-198507000-00012
  14. Uda H, Sugawara Y, Niu A, Sarukawa S. Treatment of lateral ray polydactyly of the foot: focusing on the selection of the toe to be excised. Plast Reconstr Surg. 2002;109:1581-91. https://doi.org/10.1097/00006534-200204150-00015
  15. Filges I, Kang A, Hench J, et al. Fetal polydactyly: a study of 24 cases ascertained by prenatal sonography. J Ultrasound Med. 2011;30:1021-9. https://doi.org/10.7863/jum.2011.30.7.1021
  16. Ermito S, Dinatale A, Carrara S, Cavaliere A, Imbruglia L, Recupero S. Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography. J Prenat Med. 2009;3:18-22.