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
