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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 642-648
DOI: 10.1055/s-0041-1731797
Artigo Original
Mão

Bilobed Flap in Hand Clinodactyly Reconstruction: Technique Description and Result Appraisal

Article in several languages: português | English
Ricardo Kaempf 
1   Departamento de Cirurgia da Mão, Hospital da Santa Casa de Misericórdia, Porto Alegre, RS, Brasil
,
João Pedro Farina Brunelli 
2   Departamento de Cirurgia da Mão da Santa Casa de Misericórdia, São Paulo, SP, Brasil
,
Márcio Aurelio Aita 
3   Departamento de Cirurgia da Mão, Faculdade de Medicina do ABC, Santo André, SP, Brasil
,
Pedro J. Delgado 
4   Departamento de Cirurgia da Mão, Hospital Universitário Madrid Montepríncipe, Universidad San Pablo CEU, Boadilla del Monte, Madrid, Espanha
,
Francisco Soldado 
5   Departamento de Cirurgia da Mão, Universitat de Barcelona, Barcelona, Espanha
,
Enrique Vergara 
6   Departamento de Ortopedia e Traumatologia, Especialidade Mão, Universidad Nacional de Colombia, Colômbia
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Abstract

Objective 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 the 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 conducted between January 2008 and January 2015. Five patients were included in the study, including nine operated digits. Surgical indication consisted of angular deviations ˃ 30o. Neither patients with thumb deformities nor those with deformities associated to syndromes were excluded from the study. We assessed the functional and cosmetic outcomes of the technique, as well as complications and the satisfaction rates of the family.

Results 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.

Conclusion Bilobed flap for the treatment of hand clinodactyly is a good option for skin cover after the osteotomy.

Keywords

clinodactyly - figers/abnormalities - surgical flaps - osteotomy

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Note

Work developed at the Hospital Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.




Publication History

Received: 30 November 2020

Accepted: 11 February 2021

Article published online:
01 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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