Abnormal triangular epiphysis causing angular deformity of the thumb. 2006

Goo Hyun Baek, and Moon Sang Chung, and Hyun Sik Gong, and Sanglim Lee, and Young Ho Lee, and Hyoung Ho Kim
Department of Orthopedic Surgery, Seoul National University College of Medicine, Chongno-gu, Seoul, Korea. ghbaek@snu.ac.kr

OBJECTIVE To present a triangular-shaped abnormal secondary ossification center of the distal phalanx causing angular deformity of the thumb and the surgical outcome of corrective closing-wedge osteotomy for this deformity. METHODS We treated 6 patients with abnormal triangular epiphysis in the distal phalanx of the thumb, including 3 bilateral cases. The average age was 43 months and there were 2 boys and 4 girls. Of the 9 thumbs intraepiphyseal closing-wedge osteotomy was performed in 5 and proximal phalangeal closing-wedge osteotomy was performed in 4. We measured the deformities in degrees of angulation and the range of motion of the interphalangeal (IP) joint. The average duration of the follow-up period was 27 months after the surgery. RESULTS Preoperative angular deformity of ulnar deviation averaged 30 degrees , which was reduced to an average of 12 degrees after osteotomy at the last follow-up assessment. All osteotomies healed and there was no evidence of physeal or articular damage. Interphalangeal joint range of motion did not decrease after surgery in all cases. Patients and parents were satisfied with the results of the surgery, although mild deformity persisted in the interphalangeal joint when in the flexed position after proximal phalangeal osteotomy. CONCLUSIONS Abnormal triangular epiphysis causing angled thumb is different from delta bone and can be treated with either intraepiphyseal or proximal phalangeal closing-wedge osteotomy. The intraepiphyseal procedure, however, could achieve better deformity correction regardless of the interphalangeal joint position. METHODS Therapeutic, Level IV.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004838 Epiphyses The head of a long bone that is separated from the shaft by the epiphyseal plate until bone growth stops. At that time, the plate disappears and the head and shaft are united. Epiphysis
D005260 Female Females
D005384 Finger Joint The articulation between the head of one phalanx and the base of the one distal to it, in each finger. Interphalangeal Joint of Hand,Interphalangeal Joint of Finger,Finger Interphalangeal Joint,Finger Interphalangeal Joints,Finger Joints,Hand Interphalangeal Joint,Hand Interphalangeal Joints,Joint, Finger,Joints, Finger
D006228 Hand Deformities, Congenital Alterations or deviations from normal shape or size which result in a disfigurement of the hand occurring at or before birth. Congenital Hand Deformities,Congenital Hand Deformity,Deformities, Congenital Hand,Deformity, Congenital Hand,Hand Deformity, Congenital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013933 Thumb The first digit on the radial side of the hand which in humans lies opposite the other four. Thumbs

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