RT Journal
A1 Baek, Goo Hyun
A1 Gong, Hyun Sik
A1 Chung, Moon Sang
A1 Oh, Joo Han
A1 Lee, Young Ho
A1 Lee, Sang Ki
T1 Modified Bilhaut-Cloquet Procedure for Wassel Type-II and III Polydactyly of the Thumb
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2007
FD March 1
VO 89
IS 3
SP 534
OP 541
DO 10.2106/JBJS.F.00812
UL http://dx.doi.org/10.2106/JBJS.F.00812
AB Background: The Bilhaut-Cloquet operation is a combined surgical
procedure for the treatment of a symmetric bifid thumb. Although this
procedure can obtain a normal-sized thumb with a stable interphalangeal joint,
it has limitations, such as the technical difficulty of combining all segments
of a duplicated thumb, possible later physeal growth arrest, joint stiffness,
and nail-plate deformity. We reviewed the results of our modification of this
procedure for the treatment of Wassel type-II and III polydactyly of the
thumb.Methods: Seven patients, two with type-II and five with type-III
polydactyly of the thumb, underwent the modified Bilhaut-Cloquet procedure and
were followed for an average of fifty-two months. Cosmetic and functional
assessments were made.Results: All patients and their parents were satisfied with the
cosmetic and functional results. Compared with the preoperative motion, the
postoperative range of motion of the interphalangeal joint was preserved in
thumbs with type-III deformity and was increased in those with type-II
deformity. No nail deformity or growth arrest occurred, and remodeling and
hypertrophy of the distal phalanx occurred with time.Conclusions: Our modification of the Bilhaut-Cloquet procedure for
the treatment of type-II and III thumb polydactyly is effective in preserving
interphalangeal joint motion, minimizing nail deformity, and preventing growth
arrest.Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.