title: Modified Bilhaut-Cloquet procedure for Wassel type-II and III polydactyly of the thumb.
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. ghbaek@snu.ac.kr
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.forename: Moon Sang
authors.initials: MS
authors.lastname: Chung
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Sang Ki
authors.initials: SK
authors.lastname: Lee
mesh_terms: 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