Closing Wedge Osteotomy of Abnormal Middle Phalanx for Clinodactyly

Ali, Munawar; Jackson, Teresa; Rayan, Ghazi M.

doi:10.1016/j.jhsa.2009.01.007

Cited by 27 publications

(28 citation statements)

References 13 publications

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“…This contrasts to closing-wedge osteotomy, which will further shorten an already shortened digit. 11,13 Extensor laxity, as described by Al-Qattan in the closing wedge osteotomy, 13 has not been encountered in our series. Instead, the extensor mechanism may be placed under tension with opening of the osteotomy, which may explain the loss of DIP flexion in some of our patients.…”

Section: Discussionsupporting

confidence: 45%

“…Ali et al reviewed the outcomes of 25 digits (20 small, 4 index, and 1 middle finger) with more than 25° angulation treated with closing wedge osteotomy in 17 patients aged one to 15 years. 11 At a follow-up of 6 years, the mean clinical angulation had improved from 33° to 9 degrees, radiographic angulation improved from 29° to 5 degrees, and range of motion was maintained. While the effect of closing wedge osteotomy on finger length and extensor laxity was not specifically investigated, these results are favorable.…”

Section: Discussionmentioning

confidence: 88%

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Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Little Finger Clinodactyly

Piper

Goldfarb

Wall

2015

The Journal of Hand Surgery

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Purpose To evaluate the outcomes and complications in a series of children with clinodactyly treated with opening wedge osteotomy of the abnormal phalanx. Methods We performed a retrospective review of all children with clinodactyly treated at our institution with opening wedge osteotomy of the abnormal middle phalanx between 2003 and 2013. Patients with concomitant pathology or prior surgery in the affected finger were excluded. Pre and postoperative clinical angle, radiographic angle, digital range of motion, and pain were compared, and complications were recorded. Results Thirteen digits in 9 patients were included. All had greater than 20° of preoperative clinical angulation (mean 36°). Mean age at the time of surgery was 11 years and mean duration of follow-up was 25 months (12–43 months). All digits had significant improvement (mean 32°) in clinical and radiographic angles after surgery. This improvement was maintained at final follow-up in 12 digits. Six patients had pain preoperatively and no patient had pain postoperatively. One digit had a recurrent deformity at final follow-up, and 3 digits developed stiffness at the distal interphalangeal joint. Conclusions Opening wedge osteotomy is an effective treatment for angulation in children with clinodactyly. We counsel families regarding the risk of distal interphalangeal joint stiffness. Level of Evidence: Therapeutic Level IV

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Section: Discussionsupporting

confidence: 45%

Section: Discussionmentioning

confidence: 88%

Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Little Finger Clinodactyly

Piper

Goldfarb

Wall

2015

The Journal of Hand Surgery

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“…At a follow-up of 6 years, the mean clinical angulation had improved from 33 degrees to 9 degrees. The radiographic angulation had improved from 29 degrees to 5 degrees, the and range of motion was maintained (9) .…”

Section: Discussionmentioning

confidence: 94%

http://www.iqnjm.com/wp-content/uploads/2020/01/Unmet-health-care-work-s-2-No..pdf

Almajidy

Naji

2020

IqNJM

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Background: Clinodactyly or inclination of the digits, particularly the fifth digit, is a congenital anomaly of the hand that occurs in 1% to 19.5% of the population. This deformity requires reconstruction of both the functional and the aesthetic appearance of the finger, if it is severe, to avoid future growth deformity. Objective: The study aims to review the outcomes and the complications associated with closing and reverse wedge osteotomy techniques for treating clinodactyly. Patients and Methods: Ten patients’ ten fingers with clinodactyly were submitted for reconstruction from March 2014 to May 2016 in the Al Wasity teaching hospital in Baghdad. They were treated using the closing and reverse wedge osteotomy techniques. In the closing wedge procedure, a wedge was removed from the most convex part of the middle phalanx. Subsequently, the finger is aligned in the midaxial plane and repaired with 2 K-wires. In the reverse wedge osteotomy, the wedge was rotated 180 degrees and reinserted into the bone gap with the wide end first. This buttressed the osteotomy open. Subsequently, the K-wires were inserted in retrograde fashion, maintaining the graft’s position. Then, dressing was applied with the small splint from the PIP to the tip of the finger. Results: After a 15-month follow-up, all the patients showed satisfactory results aesthetically and the functionally—with full range of motion. There was no recurrence in any case. Only one case had residual angulation and no major complications were encountered. Conclusion: The closing and reverse wedge osteotomy was proven effective in treating clinodactyly. The closing wedge is simpler than the reverse wedge. The technical difficulty of reverse wedge osteotomy may make it a less appealing option to surgeons but the outcomes we had were rewarding, both techniques provided good overall correction of angulation in one stage, and straightforward procedure, with few complications, good aesthetic outcome and patient satisfaction with improved function. Keywords: clinodactyly, closing wedge, reverse wedge

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“…Numerous surgical options can lead to functional (and aesthetic) improvement, including osteotomy (opening wedge, closing wedge, or reverse) and physiolysis. Recently, Ali et al 18 reported outcomes for 25 fingers with greater than 25°of angulation treated with a closing wedge osteotomy. At a mean of 6 years after surgery, the fingers maintained a corrected clinical position of 9°o f angulation (33°before surgery).…”

Section: Clinodactylymentioning

confidence: 99%

Congenital Hand Differences

Goldfarb

2009

The Journal of Hand Surgery

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Closing Wedge Osteotomy of Abnormal Middle Phalanx for Clinodactyly

Cited by 27 publications

References 13 publications

Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Little Finger Clinodactyly

Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Little Finger Clinodactyly

http://www.iqnjm.com/wp-content/uploads/2020/01/Unmet-health-care-work-s-2-No..pdf

Congenital Hand Differences

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