title: Correction of Clinodactyly by Early Physiolysis: 6-Year Results.
abstract: OBJECTIVE
  To review results at least 6 years after physiolysis for treatment of the delta phalanx associated with clinodactyly.
  
  
  METHODS
  We present 22 cases of clinodactyly treated with physiolysis in which we removed the central part of the epiphysis, which is the portion restricting longitudinal growth unilaterally and inducing progressive finger deviation, and placed a fat graft in the resultant defect.
  
  
  RESULTS
  This retrospective study reports the results of early physiolysis in 27 fingers with radial clinodactyly, including 17 fingers from 17 patients previously reported and 10 little fingers from 5 additional patients. All patients had a minimum follow-up of 6 years. Mean preoperative angle was 38° (range, 25° to 47°). At final follow-up, mean angle was 8° (range, 0° to 24°), a mean correction of 79%. Twelve fingers in 9 patients had more than 10° of deformity at final follow-up, whereas 15 fingers in 13 patients had a residual deformity of less than 10°, which is effectively full correction of a clinodactyly. No patient required a closing wedge osteotomy later for insufficient correction.
  
  
  CONCLUSIONS
  These accumulative findings confirm our previous preliminary report. Early physiolysis is a quick and simple procedure that allows for growth and partial but often adequate correction of the clinodactyly. The correction occurs slowly over a period of years, which can be seen as a disadvantage, and requires careful counseling of the parents.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedics, Hospital de Gran Canaria, Docteur Pasteur Sin, Las Palmas, Gran Canaria, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Medina
authors.affiliation: Department of Orthopaedics, Hospital de Gran Canaria, Docteur Pasteur Sin, Las Palmas, Gran Canaria, Spain.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lorea
authors.affiliation: Department of Orthopaedics, Hospital de Gran Canaria, Docteur Pasteur Sin, Las Palmas, Gran Canaria, Spain. Electronic address: david@david-elliot.co.uk.
authors.forename: David
authors.initials: D
authors.lastname: Elliot
authors.affiliation: Department of Orthopaedics, Hospital de Gran Canaria, Docteur Pasteur Sin, Las Palmas, Gran Canaria, Spain.
authors.forename: Guy
authors.initials: G
authors.lastname: Foucher
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D005385:Fingers / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
keywords: Clinodactyly; bracket epiphysis; delta phalanx; physiolysis