Kodama Akira, Ishibashi Shigeki, Munemori Masaru, Tsuji Kentarou, Adachi Nobuo
Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN.
Cureus. 2024 Jan 31;16(1):e53285. doi: 10.7759/cureus.53285. eCollection 2024 Jan.
In this report, we present the combination of on-top plasty with a modified Bilhaut-Cloquet procedure for treating atypical radial polydactyly with duplication at the metacarpophalangeal (MP) joint and triphalangism of the radial and ulnar phalanges, hypoplastic middle phalanx of the radial thumb, and hypoplastic phalanx base of the ulnar thumb. To preserve the stable MP and interphalangeal joints of the radial and ulnar thumbs, respectively, on-top plasty involved osteotomizing the middle phalanx and transferring the distal end of the middle phalanx of the ulnar finger to the phalanx base of the radial thumb. A modified Bilhaut-Cloquet procedure was used to combine the tips and nails of both thumbs. Twelve months postoperatively, good joint alignment and thumb tip appearance were achieved. On-top plasties effectively combined the desirable parts of both thumbs. The modified Bilhaut-Cloquet technique is particularly well-suited for atypical cases, such as the present case.
在本报告中，我们介绍了一种将覆盖成形术与改良的Bilhaut-Cloquet手术相结合的方法，用于治疗掌指关节处有重复、桡侧和尺侧指骨有三节指骨、桡侧拇指中节指骨发育不全以及尺侧拇指指骨基底发育不全的非典型桡侧多指畸形。为了分别保留桡侧和尺侧拇指稳定的掌指关节和指间关节，覆盖成形术包括对中节指骨进行截骨，并将尺侧手指中节指骨的远端转移至桡侧拇指的指骨基底。采用改良的Bilhaut-Cloquet手术将两个拇指的指尖和指甲合并。术后12个月，实现了良好的关节对线和拇指指尖外观。覆盖成形术有效地合并了两个拇指的理想部分。改良的Bilhaut-Cloquet技术特别适用于非典型病例，如本病例。
