View
231
Download
0
Category
Tags:
Preview:
Citation preview
Modified Bilhaut-Cloquet Procedure for Wassel Type-II and III Polydactyly of the Thumb
by Goo Hyun Baek, Hyun Sik Gong, Moon Sang Chung, Joo Han Oh, Young Ho Lee, and Sang Ki Lee
JBJS Essent Surg TechVolume os-90(Supplement 2 Part 1):74-86
March 1, 2008
©2008 by The Journal of Bone and Joint Surgery, Inc.
The modified Bilhaut-Cloquet procedure applied to a Wassel type-II bifid thumb.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Photograph of a type-II bifid thumb of a ten-month-old girl.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Radiograph showing hypoplasia of the bifid thumbs when compared with the thumb on the normal side.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Soft tissue between the bifid thumbs is resected along the incision line.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
The bases of the two distal phalanges are separated with use of a number-5 scalpel.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
The distal phalangeal bones of the fillet flap and the main digit (as demonstrated here) are trimmed with use of a small rongeur to facilitate approximation.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
A transverse Kirschner wire or a spinal needle can be used for rotational control of the combined distal phalanges.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Manipulation of the wire or needle can make the contour of the nail bed more round.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Axial rotation of the distal phalangeal bone is necessary to achieve a semicircular nail bed (right bottom).
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
The nail fold and nail bed are repaired with 8-0 nylon sutures under slight tension.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
The final intraoperative appearance following the modified Bilhaut-Cloquet procedure.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
The modified Bilhaut-Cloquet procedure for a Wassel type-III bifid thumb.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Goo Hyun Baek et al. J Bone Joint Surg Am 2008;os-90:74-86
©2008 by The Journal of Bone and Joint Surgery, Inc.
Recommended