gms | German Medical Science

Objectives/Interrogation: Clinodactyly is a congenital hand deformity that is characterized by coronal angular deviation and may occur in thumbs or fingers. Surgical treatment is indicated for severe angulations. Among described techniques, one of the options consists of bone alignment by wedge-shaped addition osteotomy of the anomalous phalanx. Such alignment maneuver creates a problem in skin cover, along with soft tissue tension at the concave aspect of the deformity. Hence, some sort of skin flap is required for the adequate operative wound closure. We aim to demonstrate the aforementioned technique, and to assess the results of bilobed flap in the treatment of hand clinodactyly.

Methods: Retrospective study of patients that were submitted to this surgical procedure between January 2008 and January 2017. Five patients were included in the study, including nine operated digits. Surgical indication consisted of angular deviations above 30 degrees. Patients with thumb deformities, as well as those deformities associated to syndromes, were not excluded from the study. Functional and cosmetic outcomes with the technique were assessed, as well as complications and the satisfaction rates of the family.

Results and Conclusions: All patients had satisfactory functional and cosmetic results, with a mean skin healing of 18.6 days. Among nine operated digits, only one of the patients presented vascular compromise at the distal portion of the first flap lobe, albeit without necrosis or the need for any additional procedure. Patients were followed up on a minimum of 12-month interval. No deformity recurred during the observation period.

The use of bilobed flap for the treatment of hand clinodactyly is a good option for skin cover after the osteotomy (Figure 1 [Fig. 1]).