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.

Correction of Wassel type IV thumb duplication with zigzag deformity: results of a new method of flexor pollicis longus tendon relocation

2012 ◽  
Vol 38 (3) ◽  
pp. 272-280 ◽  
Author(s):  
C. H. Lee ◽  
H. Y. Park ◽  
J. O. Yoon ◽  
K. W. Lee
Keyword(s):  
Treatment Algorithm ◽  
Suture Technique ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Type Iv ◽  
Pull Out ◽  
Thumb Duplication ◽  
Flexor Pollicis Longus Tendon ◽  
Pull Out Suture

The purpose of this study is to present a treatment algorithm and a method of flexor pollicis longus tendon relocation for Wassel type IV thumb duplication with zigzag deformity. Forty-two thumbs in 42 patients were included in this study and the mean follow-up was 4 years. In addition to excision of the extra digit, tendon relocation and metacarpal and/or proximal phalangeal osteotomy were carried out, based on the degree of angulation at the metacarpophalangeal and interphalangeal joints. Tendon relocation was achieved using our pull-out suture technique. The results were assessed using an evaluation form for thumb polydactyly provided by the Japanese Society for Surgery of the Hand. At the time of latest clinical contact, eight cases were rated good, 31 cases fair, and three cases poor. It is useful to decide surgical procedures according to the degree of angulation of the metacarpophalangeal and interphalangeal joints and flexor pollicis longus tendon relocation is important to prevent malalignment at the interphalangeal joint.

Outcomes of Opening Wedge Osteotomy to Correct Angular Deformity in Clinodactyly

2014 ◽  
Vol 39 (9) ◽  
pp. e18-e19
Author(s):  
Samantha L. Piper ◽  
Charles A. Goldfarb ◽  
Lindley Wall
Keyword(s):  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge

scholarly journals Comparison of osteotomy technique and jig type in completion of distal femoral osteotomies for correction of medial patellar luxation

2017 ◽  
Vol 30 (01) ◽  
pp. 28-36 ◽  
Author(s):  
Lisa Piras ◽  
Bruno Peirone ◽  
Derek Fox ◽  
Matteo Olimpo
Keyword(s):  
Clinical Significance ◽  
Frontal Plane ◽  
Transverse Plane ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Femoral Bone ◽  
Radiographic Assessment ◽  
Opening Wedge ◽  
Different Types ◽  
Osteotomy Technique

SummaryObjectives: Femoral osteotomies are frequently completed to correct malalignment associated with patellar luxation. The objectives of this study were to compare the use of: 1) two different types of jig; and 2) different types of osteotomy in the realignment of canine femoral bone models which possessed various iterations of angular deformity.Methods: Models of canine femora possessing distal varus, external torsion and a combination of varus and torsion underwent correction utilizing two alignment jigs (Slocum jig and Deformity Reduction Device) and either a closing wedge ostectomy (CWO) or an opening wedge osteotomy (OWO). Post-correctional alignment was evaluated by radiographic assessment and compared between groups.Results: The use of the Slocum jig resulted in frontal plane overcorrection when used with CWO in models of femoral varus, and when used with OWO in models of femoral varus and external torsion when compared to other techniques. The Deformity Reduction Device tended to realign the frontal plane closer to the post-correction target value in all angulation types. The use of both jigs resulted in undercorrection in the transverse plane in models with varus and torsion.Clinical significance: Jig selection and osteotomy type may lead to different post-correctional alignment results when performing distal femoral osteotomies. Whereas OWO allows accurate correction when used with either jig to address frontal plane deformities, the Deformity Reduction Device can be utilized with both CWO and OWO to correct torsion-angulation femoral deformities to optimize frontal plane alignment.

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

2015 ◽  
Vol 40 (5) ◽  
pp. 908-913.e1 ◽  
Author(s):  
Samantha L. Piper ◽  
Charles A. Goldfarb ◽  
Lindley B. Wall
Keyword(s):  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Little Finger

TRAPEZOID ROTATIONAL BONE GRAFT OSTEOTOMY FOR METACARPAL AND PHALANGEAL FRACTURE MALUNION

2007 ◽  
Vol 32 (3) ◽  
pp. 282-288 ◽  
Author(s):  
F. C. YONG ◽  
S. H. TAN ◽  
B. P. B. TOW ◽  
L. C. TEOH
Keyword(s):  
Bone Graft ◽  
Corrective Osteotomy ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Metacarpal Head ◽  
Bone Length ◽  
Double Osteotomy ◽  
Bone Shortening ◽  
Phalangeal Fracture

Metacarpal and phalangeal fracture malunions with significant angulation deformity are associated with bone shortening, prominence of the metacarpal head in the palm or pseudoclaw deformity and may be symptomatic. If so, they may need corrective osteotomy procedures. Conventional methods of closing, or opening, wedge osteotomy do not restore the length of the bone exactly. Simultaneous correction of the angular deformity and restoration of bone length can be addressed by a trapezoid rotational bone graft osteotomy. A double osteotomy is done and the segment of bone is rotated and re-inserted as a bone graft. This was done successfully in four metacarpal and two phalangeal fracture malunions with angulation deformities.

Treatment of a Paediatric Distal Femoral Malunion Deformity

2018 ◽  
Vol 31 (03) ◽  
pp. 222-228
Author(s):  
Greta Pavarotti ◽  
Randy Boudrieau
Keyword(s):  
Bone Growth ◽  
External Rotation ◽  
Guide Wire ◽  
Deformity Correction ◽  
Valgus Deformity ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Distal Epiphysis ◽  
Femoral Deformity

Objective The aim of this article was to describe the surgical re-alignment technique and stabilization of a distal femoral deformity in a 6-week-old, male, Foxhound. Methods A healing metaphyseal fracture, resulting in a valgus deformity with internal rotation, was observed just proximal to the distal femoral physis. The deformity was treated by an opening wedge osteotomy with lateral translation and external rotation of the distal epiphysis using a guide-wire technique; a corticocancellous allograft bridged the defect, which was stabilized with a 2.0-mm locking Y-plate designed for human phalangeal fractures. Results Successful deformity correction was obtained with subsequent healing of the osteotomy and maintained longitudinal bone growth. Sciatic neurapraxia developed as a result of a migrating adjunct pin (9 days post-operatively), which was removed. At long-term follow-up (4 years), a 12% shortening of the femur did result in addition to an asymptomatic grade 2 medial patellar luxation (MPL). The cause of the MPL was not evident; the owners declined treatment and the dog continued to function as an active hunting dog. Clinical Significance Prior to ossification of the epiphyses in very young animals, which precludes effective radiographic pre-planning, the guide-wire technique can be utilized as the primary tool for performing angular deformity correction. Adequate fixation and stabilization can be obtained with small human specialty locking plates.

scholarly journals Tratamiento artroscópico de las lesiones tipo 1B del fibrocartílago triangular

2004 ◽  
Vol 32 (65) ◽  
pp. 008-017
Author(s):  
C. Reina ◽  
M. Gutiérrez ◽  
A. Luna ◽  
F. Martín ◽  
J. Sánchez-Heredero ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Distal Radioulnar Joint ◽  
Variable Number ◽  
Suture Technique ◽  
Regeneration Ability ◽  
Radioulnar Joint ◽  
Pull Out ◽  
Triangular Fibrocartilage ◽  
Centre Of Rotation ◽  
Pull Out Suture

El complejo del fibrocartílago triangular (CFCT) desempeña un papel fundamental en la biomecánica de la muñeca. Actúa absorbiendo y transmitiendo cargas, y sirve como punto de pivote para la rotación del radio y del carpo alrededor del cúbito, por lo que funciona como centro de rotación del antebrazo. Además constituye el principal elemento estabilizador de la articulación radiocubital distal. Estudios histológicos han demostrado que la parte central del CFCT, también denominada disco articular, es avascular, mientras que su periferia está bien vascularizada, por lo que las lesiones de esta porción tienen mayor capacidad de regeneración. Las lesiones del CFCT constituyen una causa primaria de dolor en el lado cubital de la muñeca y de inestabilidad de la articulación radiocubital distal. Su tratamiento ha incluido una serie de medidas conservadoras así como un número variable de técnicas quirúrgicas, entre las que destacan en los últimos años el desbridamiento artroscópico en las lesiones centrales, y la reinserción artroscópica en las lesiones periféricas. Presentamos un estudio retrospectivo sobre los resultados del tratamiento artroscópico de las lesiones periféricas tipo 1B, realizado en 10 pacientes que fueron intervenidos quirúrgicamente en nuestro departamento entre los meses de febrero de 1999 y enero de 2002. Se realizó una reinserción artroscópica mediante técnica dentro-afuera y sutura en pull-out, obteniéndose resultados excelentes en 7 casos, buenos en 2 y malos en 1.The triangular fibrocartilage complex (TFCC) plays an important role in the biomechanics of the wrist. It acts by absorbing and transmitting loads, and serves as a pivot point for the rotation of the radiocarpal unit around the ulnar axis, and so it works as a centre of rotation for the forearm. It is also the main stabilising element of the distal radioulnar joint. Histological studies have shown that the central part of the TFCC, also known as the articular disc, is avascular, while its periphery is well vascularised, and so lesions in this section have a greater regeneration ability. TFCC lesions are a primary cause of pain in the ulnar side of the wrist and instability of the distal radioulnar joint. Treatment for this has included a series of conservative measures as well as a variable number of surgical techniques, particularly in recent years arthroscopic debridement in central lesions and athroscopic reinsertion in peripheral lesions. We present a retrospective study of the results of arthroscopic treatment of type 1B lesions, carried out on 10 patients who were operated on in our department between February 1999 and January 2002. Arthroscopic reinsertion was carried out using the internal-external and pull-out suture technique, with excellent results being obtained in 7 cases, good results in 2, and an unfavourable result in 1 case.

CORRECTIVE OSTEOTOMY AND LOCAL BONE GRAFTING FOR EXTRA-ARTICULAR MALUNION OF THE PROXIMAL PHALANX

Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 399-403
Author(s):  
John T. Capo ◽  
Ben Shamian ◽  
Philip K. Lim
Keyword(s):  
Bone Graft ◽  
Hand Function ◽  
Corrective Osteotomy ◽  
Proximal Phalanx ◽  
Wedge Osteotomy ◽  
Angular Deformity ◽  
Opening Wedge ◽  
Local Bone ◽  
Dual Plating ◽  
Osteotomy Technique

Corrective osteotomies are often utilised to treat finger deformities that may occur due to a phalangeal malunion. Rotational or angular malalignment, in addition to shortening of the digit may negatively affect hand function and be aesthetically displeasing. Thorough preoperative examination of the malunion and its associated deformities is crucial in determining the type of osteotomy technique to be used. Osteotomies can create bony defects that need to be filled with bone graft or some type of graft substitute. We describe an opening wedge osteotomy with local cancellous bone graft combined with dual plating to treat a dorsal angular deformity in a proximal phalangeal malunion.

Sign in / Sign up

Export Citation Format

Share Document