Modified Bilhaut-Cloquet procedure for Wassel type-II and III polydactyly of the thumb.
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.
Baek
Goo Hyun
GH
Department of Orthopedic Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. ghbaek@snu.ac.kr
Gong
Hyun Sik
HS
Chung
Moon Sang
MS
Oh
Joo Han
JH
Lee
Young Ho
YH
Lee
Sang Ki
SK
D002675:Child, Preschool; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D017060:Patient Satisfaction; D017689:Polydactyly / Q000601:surgery*; D013933:Thumb / Q000002:abnormalities* / Q000601:surgery