The Bilhaut-Cloquet Procedure for Wassel Types III, IV and VII Thumb Duplication

2007 ◽  
Vol 32 (6) ◽  
pp. 684-693 ◽  
Author(s):  
M. A. TONKIN ◽  
N. W. BULSTRODE
Keyword(s):  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Motion ◽  
Thumb Duplication

Five cases of Wassel types III, IV and VII thumb duplication underwent a Bilhaut-Cloquet procedure. A stable and mobile metacarpophalangeal joint was achieved in all cases. Interphalangeal joint motion was limited but this joint was stable in all cases. The nail ridge in these thumbs was minimal. A strong, stable thumb of normal size and good appearance can result from the Bilhaut-Cloquet procedure. When one nail is 70% of normal width, a modified procedure using the whole of one nail will avoid the nail ridge, but the nail will still differ from normal.

Factors affecting surgical results of Wassel type IV thumb duplications

2013 ◽  
Vol 39 (9) ◽  
pp. 934-943 ◽  
Author(s):  
A. U. C. Patel ◽  
M. A. Tonkin ◽  
B. J. Smith ◽  
A. H. Alshehri ◽  
R. D. Lawson
Keyword(s):  
Ulnar Collateral Ligament ◽  
Parent Satisfaction ◽  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Motion ◽  
Joint Stability ◽  
Type Iv ◽  
Nail Deformity ◽  
The Mean

The aim of this study is to review the outcomes of Wassel type IV thumb duplications with a minimum of one year follow-up, and to identify any factors that may compromise the quality of results. Forty one patients (42 thumbs) returned for assessment of thumb alignment, metacarpophalangeal joint and interphalangeal joint stability and motion; carpometacarpal joint motion; pinch and grip strengths; and thumb size. The subjective assessment considered thumb shape and contour, scarring, nail deformity and examiner and patient/parent satisfaction. The mean age at surgery was 16 months and the mean follow-up time was 79 months. Metacarpophalangeal joint and interphalangeal joint mal-alignment was present in 56% and 38% of cases, respectively. Interphalangeal ulnar collateral ligament laxity was significant. Metacarpophalangeal joint and interphalangeal joint motion was significantly decreased. Pinch and grip strength measurements were normal. A novel and comprehensive assessment scale is introduced, which revealed results of one (2.5%) excellent, 23 (59%) good, 14 (36%) fair and one (2.5%) poor. We consider that greater attention should be directed to the avoidance of mal-alignment and instability to improve these results.

The Bilhaut-Cloquet Procedure Revisited

Hand Surgery ◽  
1997 ◽  
Vol 02 (01) ◽  
pp. 67-74 ◽  
Author(s):  
Ma Tonkin ◽  
Km Rumball
Keyword(s):  
Interphalangeal Joint ◽  
Joint Motion ◽  
Thumb Duplication

We have found the Bilhaut-Cloquet procedure, with certain modifications, to be a useful method of reconstruction of thumb duplication. Seven thumbs were reviewed at an average follow-up of two years. A thumb of normal size and stability was obtained. Interphalangeal joint motion was 50% of normal. Nail ridging was considered to be less than satisfactory in one case only.

Arthroplasty in the hand: what works and what doesn’t?

2021 ◽  
pp. 175319342110177
Author(s):  
Daniel B. Herren ◽  
Hajime Ishikawa ◽  
Marco Rizzo ◽  
Mark Ross ◽  
Michael Solomons
Keyword(s):  
Surgical Technique ◽  
Metacarpophalangeal Joint ◽  
Distal Radioulnar Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Carpometacarpal Joint ◽  
Thumb Carpometacarpal Joint ◽  
Radioulnar Joint ◽  
What Works ◽  
Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

Osteoarthritis of the Interphalangeal and Metacarpophalagneal Joints of the Hand

2020 ◽  
Author(s):  
Andrew J. Straszewski ◽  
Jennifer Moriatis Wolf
Keyword(s):  
Hyaluronic Acid ◽  
Physical Examination ◽  
Female Gender ◽  
Metacarpophalangeal Joint ◽  
Interphalangeal Joint ◽  
Hand Osteoarthritis ◽  
Progression Of Disease ◽  
Initial Work ◽  
Distal Interphalangeal ◽  
Work Up

Hand surgeons frequently treat osteoarthritis of the interphalangeal (IP) and metacarpophalangeal (MCP) joints. Age, female gender, occupation, genetics, biomechanics, obesity, and joint laxity have been implicated in the progression of disease. Physical examination and standard three-view imaging of the hand aid in initial work up. Many conservative treatments exist, including physical therapy, splinting, anti-inflammatories, and injection of corticosteroid or hyaluronic acid.  With the failure of conservative therapies, surgical management is dictated by the particular joint in question. The distal interphalangeal (DIP) joints of fingers and IP joint of the thumb are more commonly treated by arthrodesis, whereas proximal interphalangeal (PIP) joints are treated with arthroplasty. Likewise, MCP  joints of the fingers are typically managed with arthroplasty. The thumb MCP joint is more commonly fused.  This review contains 7 figures, 4 tables, and 54 references. Keywords: hand osteoarthritis, interphalangeal joint, metacarpophalangeal joint, anatomy, arthroplasty, silicone, arthrodesis, biomechanics, outcomes

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

Silicone arthroplasty versus screw arthrodesis in distal interphalangeal joint osteoarthritis

2020 ◽  
Vol 45 (6) ◽  
pp. 615-621 ◽  
Author(s):  
Lisa Neukom ◽  
Miriam Marks ◽  
Stefanie Hensler ◽  
Sylvia Kündig ◽  
Daniel B. Herren ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numeric Rating Scale ◽  
Interphalangeal Joint ◽  
Joint Motion ◽  
Distal Interphalangeal Joint ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Distal Interphalangeal ◽  
Interphalangeal Arthrodesis ◽  
Numeric Rating

The aim of this study was to evaluate patient satisfaction after distal interphalangeal joint silicone arthroplasty and compare this outcome to that achieved with screw arthrodesis. On average 4.4 years after surgery, range of motion of the distal interphalangeal joint, pain on a numeric rating scale, satisfaction, and hand appearance of 48 patients (78 treated fingers) were assessed. For arthroplasty patients, mean distal interphalangeal joint motion was 28° with an extension deficit of 17°. Pain was low for arthroplasty and arthrodesis patients with scores of 0.2 and 0.6 out of a total of 10 points, respectively. The patients in both groups were satisfied with their outcomes, but arthroplasty patients were less satisfied with the appearance. Twenty-one per cent of the arthroplasties and 15% of the arthrodeses underwent reoperation. We suggest the motion-preserving distal interphalangeal arthroplasty as an alternative to distal interphalangeal arthrodesis for patients with higher functional demands and whose joints are stable preoperatively. In patients attaching importance to hand aesthetics and for unstable joints, distal interphalangeal joint arthrodesis is preferable. Level of evidence: III

Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication

2019 ◽  
Vol 52 (02) ◽  
pp. 147-150
Author(s):  
Kun Wang ◽  
Fangxin Ai ◽  
Pan Zhou ◽  
Zhiwei Liu ◽  
Zhenbing Chen ◽  
...  
Keyword(s):  
Metacarpophalangeal Joint ◽  
Suture Technique ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Type Iv ◽  
Pull Out ◽  
Thumb Duplication ◽  
The Right ◽  
Pull Out Suture

Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.

Long-term measurement of metacarpophalangeal joint motion in the normal and rheumatoid hand

2001 ◽  
Vol 215 (6) ◽  
pp. 549-553 ◽  
Author(s):  
N K Fowler ◽  
A C Nicol
Keyword(s):  
Metacarpophalangeal Joint ◽  
Control Group ◽  
Joint Motion ◽  
Prosthetic Joint ◽  
Low Profile ◽  
Instrumented Glove ◽  
And Control ◽  
Testing Protocols ◽  
Long Term Measurement

Low-profile flexible goniometers were used in an instrumented glove to monitor metacarpophalangeal (MCP) joint usage in patients with rheumatoid arthritis and control subjects over 3 days. Statistical analysis of the results provided descriptors of total joint motion per hour, the number of movements per hour and their duration, amplitude and angular velocity. The results show the patient group to have less overall joint usage than the control group, with movements being slower and smaller and with a restricted range. Yearly rates of joint usage were derived; these values are considerably higher than predicted in prosthetic joint testing protocols.

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