Surgical treatment of clinodactyly caused by longitudinally bracketed diaphysis ("delta phalanx")

Abstract

Clinodactyly in 10 fingers (9 patients) with longitudinally bracketed diaphysis (LBD) was treated surgically with various methods. In 4 cases with LBD in the middle phalanx of a triphalangeal thumb this phalanx was removed and the ligaments reconstructed. In the other 6 digits the LBD was in the base phalanx of a thumb or in the middle phalanx of some other digit. One of these was treated in infancy with transverse resection of the bracket. In 3 cases (4 digits) wedge osteotomy with reversal of the wedge was carried out. In the remaining case simple osteotomy was performed and a wedge-shaped bonegraft was interposed in the space created. Treatment in the last-mentioned case was unsuccessful because postoperatively the graft slipped out of position, but in all other cases the results achieved appear satisfactory.