Ulnar dimelia - a review of 24 cases.

Ulnar dimelia is a very rare unilateral congenital upper limb anomaly (CULA) affecting the whole extremity. Treatment remains difficult because of the complexity and multi-level involvement. Twenty-four cases with duplicated ulna, absent radius and polydactyly from seven European centres were reviewed according to a structured list of parameters.

Spontaneous improvement of bilateral clinodactyly of the little finger with trapezoidal phalanx: a case report with a 15-year follow-up.

Clinodactyly can be produced by a longitudinal epiphyseal bracket that generates either a 'delta' or 'trapezoidal' phalanx. We present a case with a 15-year follow-up of bilateral clinodactyly of the little finger, to emphasize a 'wait-and-see' approach as self-remodelling of his phalanges occurred during growth.

Paediatric fractures of carpal bones other than the scaphoid.

Objectives: Fractures of carpal bones other than the scaphoid are rare in children. The aim of this study was to analyze results and identify risk factors for an unfavorable outcome.

Material And Methods: Children and adolescents up to the age of 16 years who sustained a carpal fracture other than in the scaphoid between 2004 and 2021 were reviewed in this single-center retrospective study.

Hand surgery in recessive dystrophic epidermolysis bullosa: Our experience with dermal substitutes.

Background: Deformities of the hands occur in most patients with recessive dystrophic epidermolysis bullosa. All structures of the hand may be involved. To restore hand function, it is necessary to identify the proper method of treatment.

One-stage circumferential limb ring constriction release and direct circular skin closure in amniotic band syndrome: a 14-case series.

The aim of the present study was to report results of direct circular suture after 1-stage circumferential resection of limb ring constriction in amniotic band syndrome. A multicentre retrospective study included 14 patients with amniotic band syndrome (mean age, 13.3 months) operated on between 2004 and 2019 by circumferential release of ≥1 ring constriction.

Helal Metatarsal Osteotomy in Apert Foot.

Background: Apert syndrome is a rare condition characterized by a craniosynostosis associated with complex bilateral malformations of the hands and feet. Although correction of syndactyly of the extremities is largely described, just a few authors have focused their attention on the gradual subluxation of the second metatarsal head during child growth, with hyper pressure, hyperkeratosis on the plantar surface and acute pain leading to walking impairment. The aim of this study is to describe our experience with the Helal metatarsal osteotomy technique on this group of patients.

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

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.

Release of partial syndactyly using a trident flap without skin grafting.

We reviewed outcomes of a modified trident flap technique in 83 patients for a series of partial syndactyly releases performed by a single operator over 30 years. Only patients with at least 3 years of follow-up (range 3 to 27 years) were included. One-hundred and twenty-seven procedures were performed for 83 patients, and no cases of flap necrosis occurred.

Physiolysis for correction of clinodactyly with delta phalanx: Early improvement.

Congenital clinodactyly known as "delta phalanx" is a congenital finger deviation caused by a middle phalanx abnormality. Progressive realignment can be achieved with normal growth through physiolysis according to Vickers. The purpose of this investigation was to identify the rate of correction in congenital clinodactyly following epiphyseal bar resection.

Insights into the pathogenesis and treatment of split/hand foot malformation (cleft hand/foot).

Cleft hand or split hand foot malformation is a sequence of phenotypes, from a minor shortening of the central digit to a complete absence of the third ray and in the most severe cases, absence of two, three or four rays. It is a rare but spectacular presentation usually involving both hands and feet. Inheritance is mostly autosomal dominant but sporadic cases without family history are also reported, resulting from a de novo mutation/deletion/duplication.

Distal Dorsal Dimelia: A Disturbance of Dorsal-Ventral Digit Development.

Purpose: Congenital palmar nail (distal dorsal dimelia [dDD]) of the hand is a rare malformation most commonly affecting the little finger. The purpose of this report was to review the features and associations of this rare disorder and discuss the suspected underlying etiology in light of our current understanding of developmental biology.

Methods: In this retrospective cohort study from 3 practices, we describe our collective experience and review the reported literature on this disorder both as an isolated condition and in conjunction with other anomalies.

Developmental biology of the upper limb.

This article aims to provide hand surgeons with current knowledge on the developmental biology of the upper limb. It will review positioning, limb bud emergence and formation of the apical ectodermal ridge. The development of the limb bud is analyzed in its three axes: proximal-distal, anteroposterior and dorsoventral.

Metacarpal lengthening in children: comparison of three different techniques in 15 consecutive cases.

Unlabelled: Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14 years.

Infantile myofibromatosis: a series of 28 cases.

Background: Infantile myofibromatosis (IM) is a rare disorder of fibroblastic/myofibroblastic proliferation in children.

Objectives: We sought to document common and unusual characteristics of patients with IM.

Methods: This was a retrospective study of 28 children diagnosed with histopathologically confirmed IM between 1992 and 2012.

Benefits of an ungual prosthesis in traumatology and reconstructive surgery of the nail.

Lesions of the nail apparatus can leave esthetic and sometimes functional sequelae. Many sequelae are the result of incorrect growth of the nail plate. During the acute phase, in the absence of a nail plate, the nail bed may keratinize or form a pyogenic granuloma, compromising harmonious regrowth of the nail plate.

Recurrence of radial bowing after soft tissue distraction and subsequent radialization for radial longitudinal deficiency.

Purpose: Centralization and radialization are the most widely reported surgical treatments for Bayne and Klug Type III and IV radial longitudinal deficiency. Prior soft tissue distraction has been introduced to improve reducibility of the deformity without skeletal resection. Satisfying long-term effects have been reported with centralization but are still unclear with radialization.

[Lipofibromatosis in the finger of a child].

Background: Lipofibromatosis is a recently classified form of benign tumor in children; it is of non-specific clinical presentation and is seen mainly on the extremities. We report a case involving the index finger of a child.

Patients And Methods: An 8-year-old boy consulted for a nodule on the palmar surface of the left index finger that had appeared 6 months earlier.

Shrinkage of skin excision specimens: formalin fixation is not the culprit.

Background: Discrepancies between cutaneous specimen sizes reported by the dermatosurgeon and the pathologist are important to evaluate because of their legal implications for malignant tumours and the downcoding of surgical acts.

Objectives: The objective of this study was to determine the magnitude of changes in size and the factors influencing the retraction of routine skin excision specimens.

Methods: Three measurements of 82 skin excision specimens--consisting of length and width of the planned surgical excision (in vivo), length, width and depth of the specimens following excision (ex vivo) and of the specimens after formalin fixation (in vitro)--were performed and compared using a nonparametric paired test.

[Surgical management of the Blauth 1 to 3A thumb hypoplasia].

Thumb hypoplasia is a sequence of congenital abnormalities, from minor hypoplastic thumb with a preserved function to complete thumb aplasia. We only discuss in this chapter on the management of the thumb hypoplasia type 1 to 3A according to the modified Blauth's classification. Their common feature is the conservative treatment, in opposition with severe hypoplastic thumbs usually treated by index pollicisation.

Anatomic variations in a cleft hand of an elder cadaveric specimen.

Cleft hand is a rare and complex malformation in which the central part of the hand is missing. Since the nineteenth century, a very small number of dissections in cleft hand have been reported and very few reports describe the soft-tissue abnormalities. We report a case of an elderly cadaveric specimen with bilateral cleft hand.

[Vascular tumors and malformations of the limbs].

According to many practitioners, any vascular swelling is a "Hemangioma". This generic term leads to much confusion: some lesions present a spontaneous regression while the others tend to worsen all the life long. The only common feature is the histological pattern.

Algorithm for treatment of apert hand.

The hand in Apert syndrome is one of the most complex examples of congenital deformity of the upper limb. The management is difficult, and mny different approaches have been published. The hands demonstrate many disturbances of soft tissue and bony structures.