• 대한정형외과학회지
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• 제53권6호
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• pp.530-539
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• 2018

목적: 족부에 발생한 선천성 축후성 다지증에 자기공명영상 검사를 실시하여 그 결과에 대해 평가하고자 한다. 대상 및 방법: 족부에 발생한 선천성 축후증 다지증 및 다지합지증으로 수술을 시행받은 347예(288명)에 대하여 단순 방사선 사진상에 나타나는 변형이 시작되는 부위에 따라 다섯 개의 군으로 분류하였다(넓은 중족골두, 이분중족, 유합된 복제, 불완전 복제, 완전복제 군). 골화가 이루어지지 않아 단순 방사선 사진상 나타나지 않는 부위에 대하여 자기공명영상 검사를 실시하여 유합 혹은 분리여부를 확인하였다. 또한 단순 방사선 사진상 지골 형성이 되지 않은 것처럼 보이는 부분에 대해서도 자기공명영상 검사를 실시하였다. 결과: 단순 방사선 사진상 골화가 이루어지지 않은 부분에 있어서 자기공명영상 검사를 실시하여 보니 잉여지와 고유지 간 유합 혹은 분리되는 양상이 다양하게 관찰되었다. 또한 지골 형성이 이루어지지 않은 듯 보이는 부분에 대해서도 지골의 상태를 효과적으로 알 수 있게 하였다. 결론: 족부에 발생한 선천성 축후성 다지증에 실시하는 자기공명영상 검사는 단순 방사선 사진에서 확인되지 않는 부분에 대한 정확한 해부학적 상태를 알려줄 수 있는 유용한 장치로 사용될 수 있다.

• 생물정신의학
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• 제5권2호
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• pp.283-287
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• 1998

The mother was 24 years old, primipara, and had been taking carbamazepine 400mg(serum concentration $5.0-8.5{\mu}g/ml$) during pregnancy without any clinical seizures. A male baby with physical malformation was delivered on week 39. The malformation is extradigit(polydactily) on X-ray of right foot and left mild hydronephrosis on ultrasonography and renal scan with radioactive material. We reported this rare case and reviewed related articles about teratogenic effect of carbamazepine, mechanism of action and prevention of teratogenesis.

• Neonatal Medicine
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• 제16권1호
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• pp.85-88
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• 2009

저자들은 우측 다리와 겨드랑이의 협착고리, 우측 발의 만곡족, 척추 측만증, 좌측 엄지 손가락의 다지증, 우측 엄지 손가락 결여증과 더불어, 두피에 피부 무형성증이 동반된 양막대증후근 1례를 경험하였기에 문헌 괓ㄹ과 함께 보고하는 바이다.

• Neonatal Medicine
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• 제16권1호
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• pp.89-93
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• 2009

저자들은 당뇨병이 임신 초기부터 진단된 산모에서 출생한 신생아에서 작은 악안면, 우측소이증, 오른손의 손가락다지증, 오른쪽 눈물샘의 위치 이상이 동반된 상검판 기형, 근위부 공장폐쇄증을 지닌 사례와 수술 후 공장 부위의 협착증을 중재적 방사선 시술로 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제3권1호
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• pp.53-57
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• 1999

Polydactyly is the most common congenital deformity of the foot. The authors present an unusal case of polydactyly of the foot in an otherwise healthy adult male. The patient has an mixed type of polydactyly composed of polysyndactyly of the first toe, Y shaped second metatarsal and polysyndactyly with the fusion to the forth toe of the fifth toe. Meticulous. preoperative plan was prepared and performed at the operation. Main procedures were as follows : 1) Excision of extradigit of first toe and first metatarsocuneiform joint fusion. 2) Excision of lateral bud of second metatarsal and plantar-medial osteotomy of the medial bud. 3) Metatarsal head resection arthroplasty of third & forth metatarsophalangeal joint and 4) Excision of medial polydactyly of the fifth toe and syndactyly release and split thickness skin graft. Postoperatively, The forefoot width was reduced from 11.5 to 9.5cm and the pain was relieved.

• 대한족부족관절학회지
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• 제5권2호
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• pp.120-128
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• 2001

Purpose: This study was undertaken to review the precise morphological patter'ns of polydactyly of the foot and to evaluate outcomes of surgical interventions. Materials and Methods: The records of patients who had polydactyly of foot from 1983 to 2000 were reviewed retrospectively. 29 duplicated toes(24 patients) were analyzed. All cases were evaluated and classified with Temtamy and McKusick's axial pattern, Watanabe's morphologic pattern and level of duplication. Clinical evaluation was performed according to Phelps and Grogan's. Mean age at surgery was 5.7 years(range: 10 months$\sim21$ years). All the patients were subsequently evaluated during mean 17 months(range: 13 months-$\sim5$ years). Results: Preaxial polydactyly was seen in 3 cases, central polydactyly in 3 cases, postaxial polydactyly in 22 cases and remaining 1 case was multiple my involvement. Only 2 patients have familial history and the most common associated anomaly was hand deformity(20.8%). Clinical results were excellent in 14 cases, good in 5 cases, poor in one. 17 patients(70%) were operated before 6 years olds and they had better results than those of who were operated after 6 years olds. Conclusion: The Method of surgical correction for the polydactyly should be individualized by its morphological pattern because the purpose of operation was to give comfort in wearing shoes and patient's psychological relief. This study showed that polydactyly of the foot could be corrected surgically with good results in most cases, and the better results would be achieved if the operation is performed before preschool age according to its individualized pattern of duplication.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.821-828
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• 2011

Purpose: The authors applied Bilhaut-Cloquet procedure to Wassel type III and IV duplicated thumb, which was limited to patients with Wassel type I, II. This procedure was applied in order to improve the growth potential, range of joint motion, joint stability and cosmetic outcome. Methods: Sixteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from May, 2005 to December, 2010. Seven patients were Wassel type III, nine patients were type IV. This procedure was applied not only to balanced type, but also unbalanced type or convergent type. Five patients were balanced type and eleven patients were unbalanced type. Convergent type of Wassel type IV was three. Sex ratio was the same, mean age at the operation was 20.1 months old (8~52 months old). Angular deformity, joint stability and range of joint motion and cosmetic outcome were considered together and estimated in Tada score. Also, postoperative subjective satisfaction score of the parents was evaluated by a 100-points scale. Results: Mean subjective satisfaction scored 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Range of motion was mean 20 degrees in interphalangeal joint and mean 73 degrees in metacarpophalangeal joint. Tada score showed 'good' in eleven patients (68.8%), 'fair' in three patients (18.7%) and 'poor' in two patients (12.5%). In seven patients those who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. Conclusion: Bilhaut-Cloquet procedure can be applied not only to balanced type of Wassel type III, IV duplicated thumb, but also to unbalanced type or convergent type that focused on functional reconstruction and cosmetic improvement.

• 대한족부족관절학회지
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• 제6권1호
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• pp.7-14
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• 2002

Purpose: We investigate the characteristic morphologic features and suggest proper treatment of postaxial polydactyly of the foot Materials and Methods: We analysed 37 cases of postaxial polydactyly. Mean post operative follow up period was 2 years 10 months. We analysed them according to morphological, radiological and operative findings. Patients were classified into extra 5th toe polydactyly and extra 6th toe polydactyly based on the abnormal extradigit, and subdivided into joint origin type, bone origin type and floating type based on duplication pattern. Results: 23 cases were extra 5th toe polydactyly and 14 cases were extra 6th toe polydactyly. Most common types were metatarsophalangeal joint origin type of extra 6th toe polydactyly. Compared with extra 5th toe polydactyly, extra 6th toe polydactyly originated from more proximal part and had not syndactylism. Conclusion: As the duplication level was more distal, degree of syndactylism and nail union was more severe. In case of syndactyly between 5th and 6th toe, abnormal extradigit was 5th toe.

• Childhood Kidney Diseases
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• 제6권2호
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• pp.266-271
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• 2002

Joubert 증후군은 소뇌 충부 무형성을 특징으로 하며 근 긴장 저하, 불규칙적인 호흡, 발달 지연, 안진, 망막 이형성, 낭종성 신질환, 간 섬유증, 다지증 등이 동반되는 증후군이다. 이 질환에서는 소뇌 충부의 병변과 신장의 병변이 무작위적으로 함께 나타나기도 하는데, 저자들은 소뇌 충부 무형성, 근 긴장저하, 안진, 무호흡 등이 있어 Joubert 증후군으로 진단받은 환아가 신장 수질 석회화 병변과 만성 신부전으로 진행한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.458-461
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• 2009

Purpose: Preaxial polydactyly is the most common congenital anomaly of upper extremities. In this study, we classified 112 patients of preaxial polydactyly for investigation of recent incidences of each types. Methods: We reviewed 120 cases of preaxial polydactyly diagnosed at university hospitals of Incheon and Bucheon from 2000 to 2008. All cases were grouped using simple radiographs and all cases were classified according to the Upton modified Iowa system. Results: Among the 120 cases of preaxial polydactyly, there were 7 cases(6%) of type I, 35 cases(29%) of type II, 1 case(1%) of type III, 48 cases(40%) of type IV, 12 cases(10%) of type V, 5 cases(4%) of type VI, 12 cases(10%) of type VII polydactyly. All cases of type VII polydactyly were triphalangism. Conclusion: Comparing with Wassel's study and Upton's study, our study showed similar distribution of each types of preaxial polydactyly.