Physiolysis for correction of clinodactyly with delta phalanx: Early improvement

Sayed, Laila El; Salon, A.; Glorion, Christophe; Guéro, S.

doi:10.1016/j.hansur.2018.12.002

Cited by 4 publications

(7 citation statements)

References 14 publications

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“…It results from a trapezoidal middle phalanx, but in rare cases, the phalanx is in a triangular shape (also called a ‘delta phalanx’), which makes the clinodactyly more pronounced. The therapeutic arsenal for clinodactylies includes observation for mild cases, Vicker’s physiolysis (El Sayed et al., 2019), or realignment osteotomy of the delta phalanx.…”

Section: Introductionmentioning

confidence: 99%

Non-vascularized toe phalanx transfer for correction of severe clinodactyly of the thumb in Rubinstein–Taybi syndrome

Mapihan

Badina

Pannier

et al. 2020

J Hand Surg Eur Vol

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In Rubinstein–Taybi syndrome, patients may have a particularly severe clinodactyly of the thumb. We evaluated a new method for correction of these severe clinodactylies using non-vascularized toe phalanx transfer as a replacement for the abnormal delta phalanx. Results of the new technique are presented, together with those of an osteotomy technique. We retrospectively recorded the angle of the clinodactyly before and after surgery and at long-term follow-up of 11 osteotomies and five transfers in nine patients from 1990 to 2017. The pre-operative angle of clinodactyli was similar between the two groups with a mean of 59°. After surgery, the correction was equivalent (7° and 11°). At the last follow-up (7 and 18 years), the relapse of clinodactyly was 17° for osteotomies and 1° for phalanx transfers. We noticed growth of the transferred phalanx, resulting in an excellent thumb length. We conclude that non-vascularized toe transfer can be an effective correction of severe clinodactyly and may be more stable than osteotomy in the long-term. Level of evidence: IV

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Section: Introductionmentioning

confidence: 99%

Non-vascularized toe phalanx transfer for correction of severe clinodactyly of the thumb in Rubinstein–Taybi syndrome

Mapihan

Badina

Pannier

et al. 2020

J Hand Surg Eur Vol

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“…In our experience, we strongly emphasize the importance of distinguishing between a delta phalanx and a trapezoidal phalanx as this would decide the type of treatment. This concept has been mentioned in other papers although not clarified (El Sayed et al, 2019). If the longitudinal epiphyseal bracket is complete, then the phalanx will have a delta shape and the angulation will worsen over time.…”

mentioning

confidence: 98%

“…Clinodactyly rarely affects hand function, and treatment should not be indicated for aesthetic reasons Journal of Hand Surgery (European Volume) 2024, Vol. 49(1) 106-108 journals.sagepub.com/home/jhs (El Sayed et al, 2019). No consensus exists on the surgical indication for clinodactyly; some authors recommend surgical treatment only for patients with impaired hand function, deviation greater than 20 and/or a worsening deformity, although functional limitations are mostly seen with angles at least above 40 (Goldfarb and Wall, 2015).…”

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confidence: 99%

“…Some authors define clinodactyly as an angulation of greater than 8°, others consider 10° an abnormal angulation while yet some surgeons would consider 15° as the cut-off (de Marinis and de Marinis, 1955). Clinodactyly rarely affects hand function, and treatment should not be indicated for aesthetic reasons (El Sayed et al., 2019). No consensus exists on the surgical indication for clinodactyly; some authors recommend surgical treatment only for patients with impaired hand function, deviation greater than 20° and/or a worsening deformity, although functional limitations are mostly seen with angles at least above 40° (Goldfarb and Wall, 2015).…”

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confidence: 99%

“…Early differentiation of delta and trapezoid phalanx with radiographs may be challenging due to the skeletal immaturity of the child, especially before 4 years of age. For this reason, some surgeons suggest the use of the magnetic resonance imaging (MRI) or ultrasonography to confirm the diagnosis (El Sayed et al., 2019). The authors of this article prefer using serial radiographs but would resort to other imaging techniques in case of doubt.…”

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confidence: 99%

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