Classification and treatment of congenital central slip hypoplasia

Yuzhou Liu; Xiuyue Xu; Le Wang; Jie Lao; Yongqing Zhuang; Yousheng Fang

doi:10.2340/jphs.v58.7262

Authors

Yuzhou Liu Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
Xiuyue Xu Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
Le Wang Department of Pediatric Surgery, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
Jie Lao Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
Yongqing Zhuang Hand and Microvascular Surgery Department, Shenzhen People’s Hospital, 2nd Clinical Medical College of Jinan University, 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
Yousheng Fang Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China

DOI:

https://doi.org/10.2340/jphs.v58.7262

Keywords:

Central slip, hypoplasia, tendon advancement, tendon graft, Level of Evidence: IV (Therapeutic Study)

Abstract

Objectives: The aim of this study is to make a diagnosis and a classification for congenital central slip hypoplasia. The surgical treatment was determined according to the classification.
Methods: A retrospective study of 25 treated digits in 13 patients with congenital central slip hypoplasia was carried out. The central slip was classified into two types. Type I: The distance between the insertion of central slip and the proximal interphalangeal joint was shorter than or equal to 5 mm. Type II: The distance between the insertion of central slip and the proximal interphalangeal joint was longer than 5 mm. Tendon advancement or tendon graft was used for type I or II, respectively.
Results: The preoperative mean extension lag was 91° (range, 80°–100°), and the mean follow-up duration was 18 months (range, 9–24 months). The postoperative mean extension lag was 19° (range, 0°–50°). No matter whether in type I or II, the postoperative ranges of proximal interphalangeal joint extension had significant improvement compared with the preoperative ones. There was no statistical difference of proximal interphalangeal joint extension lag changes before and after surgery between the two types.
Conclusion: Congenital central slip hypoplasia could be classified into two types. Either tendon advancement or tendon graft might be effective, which depended on the classification.