The principle of early treatment by physiolysis without osteotomy is based on the removal of the deforming tether. We retrospectively studied the effects of early physiolysis on the growth and correction of deformity with a minimal follow-up of 6 years in 17 cases. The mean correction at follow-up was 82% of the pre-operative angle. All operated phalanges had grown. There was no epiphyseal closure. Full correction (residual deformity of less than 10 degrees) was achieved in 11 patients. No patients needed closing osteotomy for insufficient correction. We think that early physiolysis is a quick operation which provides growth and at least partial correction of the clinodactyly.
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State of the art review: The pathogenesis and management of Madelung deformity.
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Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Madelung deformity remains a fascinating yet unresolved challenge. There is an increasing awareness for early diagnosis by healthcare providers with improvement in diagnostic modalities, however, the exact mechanisms for the development of the deformity have still to be clarified. While some corrective procedures have been described to effectively address an established deformity, the existing literature lacks clear and evidence-based treatment guidelines on how to proceed in daily practice.
View Article and Find Full Text PDFPhysiolysis for correction of clinodactyly with delta phalanx: Early improvement.
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Hospital Necker-Enfants Malades, 149, rue de Sèvres, Paris 75015, France.
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.
View Article and Find Full Text PDFTreatment of Madelung Deformity With Vicker Ligament Release and Radial Physiolyses: A Case Series.
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February 2019
Department of Orthopedic Surgery, Nationwide Children's Hospital, Columbus, OH. Electronic address:
Purpose: To evaluate the surgical outcomes in a series of Madelung wrists treated with a Vicker ligament release at a young age. We hypothesize that early treatment of Madelung deformity with Vicker ligament release is safe and may minimize progression of deformity.
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J Hand Surg Am
June 2016
Department of Orthopaedics, Hospital de Gran Canaria, Docteur Pasteur Sin, Las Palmas, Gran Canaria, Spain.
Purpose: To review results at least 6 years after physiolysis for treatment of the delta phalanx associated with clinodactyly.
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Longitudinal epiphyseal bracket.
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Department of Orthopaedic Surgery, Rady Children's Hospital and Health Center, 3030 Children's Way, Suite 410, San Diego, CA 92123 USA ; Department of Orthopaedic Surgery, University of California, San Diego, CA USA.
Longitudinal epiphyseal bracket or bracket epiphysis is an uncommon disorder of growth. Alternatively known as a delta phalanx, it is due to an anomalous secondary ossification center that extends longitudinally along the diaphysis. Although rare, longitudinal epiphyseal bracket most commonly manifests in the hands as clinodactyly and in the feet as hallux varus.
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