Closing wedge osteotomy of abnormal middle phalanx for clinodactyly.

Purpose: To report a series of clinodactyly patients to report clinical and radiographic outcomes after closing wedge osteotomy and K-wire fixation of abnormal middle phalanges.

Methods: Twenty-five fingers from 17 patients were included in the study. All patients had more than 25 degrees of angulation and were treated with closing wedge osteotomy. Subjective and objective data with radiographic assessment were compared preoperatively and postoperatively.

Results: Male gender was predominant in our series (14 of the total 17 patients). Family history was positive for clinodactyly in 4 patients. The appearance of all fingers improved after surgery. Angular deformity was corrected on average from 33 degrees preoperatively to 9 degrees postoperatively. Analysis of radiographs showed deformity correction from 29 degrees preoperatively to 5 degrees postoperatively. Preoperative and postoperative arc of motion measurements were available for 10 patients. Distal interphalangeal joint arc of motion decreased from 84 degrees prior to surgery to 81 degrees after surgery, whereas proximal interphalangeal joint arc of motion was unchanged.

Conclusions: Closing wedge osteotomy of the abnormal middle phalanx for clinodactyly has provided our patients with adequate correction of the deformity, improved hand function, and has provided high satisfaction for parents. This treatment is recommended for moderate (15 degrees to 30 degrees ) and severe (>30 degrees ) deformities.