• Archives of Plastic Surgery
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• v.38 no.6
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• pp.821-828
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• 2011

Purpose: The authors applied Bilhaut-Cloquet procedure to Wassel type III and IV duplicated thumb, which was limited to patients with Wassel type I, II. This procedure was applied in order to improve the growth potential, range of joint motion, joint stability and cosmetic outcome. Methods: Sixteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from May, 2005 to December, 2010. Seven patients were Wassel type III, nine patients were type IV. This procedure was applied not only to balanced type, but also unbalanced type or convergent type. Five patients were balanced type and eleven patients were unbalanced type. Convergent type of Wassel type IV was three. Sex ratio was the same, mean age at the operation was 20.1 months old (8~52 months old). Angular deformity, joint stability and range of joint motion and cosmetic outcome were considered together and estimated in Tada score. Also, postoperative subjective satisfaction score of the parents was evaluated by a 100-points scale. Results: Mean subjective satisfaction scored 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Range of motion was mean 20 degrees in interphalangeal joint and mean 73 degrees in metacarpophalangeal joint. Tada score showed 'good' in eleven patients (68.8%), 'fair' in three patients (18.7%) and 'poor' in two patients (12.5%). In seven patients those who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. Conclusion: Bilhaut-Cloquet procedure can be applied not only to balanced type of Wassel type III, IV duplicated thumb, but also to unbalanced type or convergent type that focused on functional reconstruction and cosmetic improvement.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.458-461
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• 2009

Purpose: Preaxial polydactyly is the most common congenital anomaly of upper extremities. In this study, we classified 112 patients of preaxial polydactyly for investigation of recent incidences of each types. Methods: We reviewed 120 cases of preaxial polydactyly diagnosed at university hospitals of Incheon and Bucheon from 2000 to 2008. All cases were grouped using simple radiographs and all cases were classified according to the Upton modified Iowa system. Results: Among the 120 cases of preaxial polydactyly, there were 7 cases(6%) of type I, 35 cases(29%) of type II, 1 case(1%) of type III, 48 cases(40%) of type IV, 12 cases(10%) of type V, 5 cases(4%) of type VI, 12 cases(10%) of type VII polydactyly. All cases of type VII polydactyly were triphalangism. Conclusion: Comparing with Wassel's study and Upton's study, our study showed similar distribution of each types of preaxial polydactyly.