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

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


Photograph of a type-II bifid thumb of a ten-month-old girl.



Radiograph showing hypoplasia of the bifid thumbs when compared with the thumb on the normal side.











Soft tissue between the bifid thumbs is resected along the incision line.



The bases of the two distal phalanges are separated with use of a number-5 scalpel.







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.



A transverse Kirschner wire or a spinal needle can be used for rotational control of the combined distal phalanges.



Manipulation of the wire or needle can make the contour of the nail bed more round.



Axial rotation of the distal phalangeal bone is necessary to achieve a semicircular nail bed (right bottom).



The nail fold and nail bed are repaired with 8-0 nylon sutures under slight tension.



The final intraoperative appearance following the modified Bilhaut-Cloquet procedure.



The modified Bilhaut-Cloquet procedure for a Wassel type-III bifid thumb.













Documents

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