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Journal of the Korean Society for Surgery of the Hand 2000;5(2):170-176.
Published online June 1, 2000.
RECONSTRUCTION OF BIFID THUMB WITH COMBINATION PROCEDURES
Duke Whan Chung, Chae Ik Chung, In Whan Chung
분리된 수지의 조합술을 이용한 선천성 이분 무지의 재건술
정덕환, 정재익, 정인환
Abstract
Authors underwent 12 cases of congenital bifid thumb which were treated by combination procedure from 1984 to 1999. The cases which were classified by Wassel classification, Type I in 2 cases, Type II in 3 cases, Type III in 2 cases, Type IV in 4 cases and Type V in 1 case. The combination procedure based on Bilhaut-Cloquet procedure and performed additional procedure depend on cases such as corrective osteotomy, arthrodesis. The average age at operation was 14 years old overall but, in the 9 cases who were treated at childhood the average age was 2.4 years old. The mean follow up period was 5.6 years. Authors concerning about the indication of procedure if the affected nail size was larger than 80% of normal thumbnail, we performed ablation simply, but less than 80%, we effort the combination reconstruction procedure of bifid thumb to normal size, appearance and motion. All of 12 cases, 10 cases show the relative good result. One patient whose ulnar side thumb flap progressed partial necrosis, dissatisfied the operation result. In all cases, they had nail deformity, 11 cases had nail grove(91%) remain one case had nail cleft, and he dissatisfied nail appearance. Although we could not evaluated range of motion of interphalangeal joint, overall view of cases we observed the decrease of range of motion of interphalangeal joint, but it was not important factor to patients in social livehood. Therefore improvement of cosmetic appearance of thumb provide better social compliance to all patients.
 
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