Bilhaut-Cloquet 변법을 이용한 이열엄지의 교정

Modified Bilhaut-Cloquet Method for Correction of Bifid Thumb

  • 손형빈 (계명대학교 의과대학 성형외과학교실) ;
  • 손대구 (계명대학교 의과대학 성형외과학교실) ;
  • 김현지 (계명대학교 의과대학 성형외과학교실) ;
  • 김준형 (계명대학교 의과대학 성형외과학교실) ;
  • 한기환 (계명대학교 의과대학 성형외과학교실)
  • Sohn, Hyung Bin (Department of Plastic and Reconstructive Surgery, Keimyung University, Dongsan Medical Center) ;
  • Son, Daegu (Department of Plastic and Reconstructive Surgery, Keimyung University, Dongsan Medical Center) ;
  • Kim, Hyun Ji (Department of Plastic and Reconstructive Surgery, Keimyung University, Dongsan Medical Center) ;
  • Kim, Jun Hyung (Department of Plastic and Reconstructive Surgery, Keimyung University, Dongsan Medical Center) ;
  • Han, Ki Hwan (Department of Plastic and Reconstructive Surgery, Keimyung University, Dongsan Medical Center)
  • 투고 : 2006.04.07
  • 발행 : 2006.07.10

초록

Purpose: As the traditional treatment of the Wassel's type I or II of bifid thumb, Bilhaut-Cloquet, has always been the standard method despite several disadvantages such as tearing of the finger nail, injuries of the growth plate, joint instability, and long visible scarring. To overcome these drawbacks, we applied a modified Bilhaut-Cloquet Method. Methods: The subjects used for the this study were 10 of 20 patients evaluated. The patients underwent modified methods under every type of Wassel's classification. We designed a central wedge Zig-Zag incision and removed the nail and bony tissues in the remaining digit, but not soft tissue if possible, and transferred the ligaments, tendons, and soft tissue to the remaining thumb from the extra digit. We evaluated the patients' lack of extension, the total ROM of the MP and IP joints, the ROM of IP joints, and the lateral deviations of the reconstructed thumb. Results: The results were encouraging, with all patients showing a good functional and aesthetic outcome. Conclusion: The modified method proved a very effective procedure in the treatment of bifid thumb in all types, especially types I or II.

키워드

참고문헌

  1. Dobyns JH, Wood VE, Bayne LG: Congenital hand deformities. In Green DP (ed): Operative Hand Surgery. 3rd ed, New york, Churchill Livingstone, 1993, p 440
  2. Ezaki M: Radial polydactyly. Hand Clin 6: 577, 1990
  3. Jobe MT, Wright II PE: Duplication(Polydactyly), In Crenshaw AH(ed): Campbell's Operative Orthopedics. 8th ed, St. Loise, Mosby Year Book, 1992, p 3391
  4. Wassel HD: The results of surgery for polydactyly of the thumb. Clin Orthop Relat Res 64: 175, 1969
  5. Temtamy SA, McKusick VA: The genetics of hand malformations. Birth Defects Orig Artic Ser 14: 1, 1978
  6. Samson P, Salazard B, Magalon G: The 'Bilhaut-Cloquet' technique for treatment of thumb duplication. Hanchir Mikrochir Plast Chir 36: 141, 2004 https://doi.org/10.1055/s-2004-817888
  7. Miura T: Duplicated thumb. Plast Reconstr Surg 69: 470, 1982
  8. Kawabata H, Tada K, Masada K, Kawai H, Ono K: Revision of residual deformities after operations for duplication of the thumb. J Bone Joint Surg Am 72: 988, 1990 https://doi.org/10.2106/00004623-199072070-00005
  9. Kozin SH: Deformities of the thumb. In Green DP(ed): Operative Hand Surgery. 5th ed, New York, Churchill Livingstone, 2005, p 1455
  10. Miura T: An appropriate treatment for postoperative Z-formed deformity of the duplicated thumb. J Hand Surg 2: 380, 1977 https://doi.org/10.1016/S0363-5023(77)80047-6
  11. Palmieri TJ: Polydactyly the thumb: incidence, etiology, classification and treatment. Bull Hasp Joint Dis 34: 200, 1973
  12. Manske PR: Treatment of duplicated thumb using a ligamentous/periosteal flap. J Hand Surg 14A: 728, 1989
  13. Tada K, Yonenobu KK, Tsuyuguchi Y, Kawai H, Egawa T: Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases. J Bone Joint Surg Am 65: 584, 1983 https://doi.org/10.2106/00004623-198365050-00002
  14. Cha GH, Kim KY, Choi SH, Seul JH: Correction of duplicated thumbs. J Korean Soc Plast Reconstr Surg 19: 492, 1992
  15. Masuda T, Sekiguchi J, Komuro Y, Nomura S, Ohmori K: 'Face to face': a new method for the treatment of polydactyly of the thumb that maximises the use of available soft tissue. Scand J Plast Reconstr Surg Hand Surg 34: 79, 2000 https://doi.org/10.1080/02844310050160213