A case of 13-year-old female with three-pairs/six-lines of labial frenulums and thumb and forefinger's deformity was reported. The frenulums of inferior lip were bigger than frenulum of superior lip. There was no family history and her mother didn't ill with infectious disease and injury in gestation.
Adolescent ; Female ; Humans ; Lip ; abnormalities ; Thumb ; abnormalities

Traumatic boutonniere deformity of the thumb is rare in non-rheumatoid patients. Non-rheumatoid patient develops a boutonniere deformity of the thumb following a closed injury to the dorsoradial aspect of the metacarpophalangeal joint. The patient had an extensor lag of the metacarpophalangeal joint and paradoxical hyperextension of the interphalangeal joint. The patient required surgical treatment which included advancement and reattachment of the extensor pollicis brevis insertion and imbrication of the dorsoradial capsule to restore the anatomical alignment of the extensor pollicis longus. Conservative care of the metacarpophalangeal joint may be effective, but once a boutonniere deformity is developed, surgical treatment is necessary.
Congenital Abnormalities* ; Humans ; Joints ; Metacarpophalangeal Joint ; Thumb*

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.
Congenital Abnormalities ; Female ; Humans ; Middle Aged ; Nails ; Thumb ; Transplants

Humans ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thumb ; abnormalities ; surgery

Six thumb reconstructions and one index reconstruction were performed by use of the wrap-around technique. All successful digital reconstructions were reviewed at an average of 37 months after surgery. There were complications related to the digits in three patients ; these included pin site infection (1), malrotation (1), and nail deformity (1). But we considered that function and cosmesis were excellent with a 100% viability rate. All patients regained protective sensation and sttained two-point discrimination (average 10mm). The wrap-around technique represents an esthetically and functionally excellent procedure of digit reconstruction for amputation at the level of metacarpo-phalangeal joint or distal to it.
Amputation ; Congenital Abnormalities ; Discrimination (Psychology) ; Fingers ; Humans ; Joints ; Sensation ; Thumb

Clinodactyly is defined as an angulation of a digit in the radio-ulnar plane. This anomaly can be congenital, dominantly inherited, or acquired due to trauma or inflammation. Although the deformity usually causes little functional impairment, correction is made because of cosmetic problems. Male subject, with polydactyly on thumb(Wassel's type VII) received first surgery at the age of one. And at the age of six, abnormal growth on the radial side of the first metacarpal bone and ulnar deviation of the distal phalanx of the thumb at the interphalangeal joint had developed. The authors used the growing bony segment from the first metacarpal bone as a bone graft for the correction of clinodactyly on thumb. Z-plasty incision was made on the concave(ulnar) side of thumb and a wedge osteotomy was made on the distal phalanx. The bone graft was inserted into the gap of the distal phalanx of the thumb and fixed it with K-wires. Deformity of the metacarpal bone and clinodactyly on thumb was corrected effectively without donor site morbidity with noticible growth of the grafted metacarpal bone 12 months after surgery.
Congenital Abnormalities ; Humans ; Inflammation ; Joints ; Male ; Osteotomy ; Polydactyly* ; Thumb* ; Tissue Donors ; Transplants*

PURPOSE: The authors applied modified Bilhaut-Cloquet procedure to convergent type of Wassel type IV duplicated thumb. In order to avoid secondary Z-deformity and dysfunction of the reconstructed thumb, the authors modified operative techniques of Bilhaut-Clopuet procedure. METHODS: Fourteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from October 2008 to May 2013. Five patients were balanced type and nine patients were unbalanced type. Mean age at the operation was 20.1 month-old (range, 12-52 month-old). Angular deformity, joint stability, range of joint motion and cosmetic outcome were estimated based on Tada score. Postoperative subjective satisfaction score of the parents was evaluated using a 100-points scale. RESULTS: Mean subjective satisfaction score was 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Mean range of motion was 20 degrees in interphalangeal joint and 73 degrees in metacarpophalangeal joint. Based on Tada score, the results were good in ten patients (72%), fair in two (14%) and poor in two (14%). Seven patients who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. CONCLUSION: Modified Bilhaut-Cloquet procedure can be applied not only to balanced type of convergent Wassel type IV duplicated thumb, but also to unbalanced type, that focused on functional reconstruction and cosmetic improvement.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Metacarpophalangeal Joint ; Parents ; Range of Motion, Articular ; Thumb*

We report a rare case of a 10-year-old girl with anomalous course of extensor pollicis longus (EPL) muscle, which exists with absence of thenar muscles and muscles in the 1st extensor compartment. Her chief complaint was severe atrophy on the right thenar eminence. On physical examination, there was no obvious functional abnormality on her right thumb. On magnetic resonance imaging, we found that the abductor pollicis brevis, opponens pollicis, abductor pollicis longus, and extensor pollicis brevis muscles were absent. The tendon of the EPL muscle was found, but it had abnormal insertion on the radial side of the proximal phalanx, not on the distal phalanx. This variation was thought to have played a major role in compensating for impaired abduction of the thumb, which is usually accompanied by agenesis of major abductors of the thumb.
Atrophy ; Congenital Abnormalities ; Magnetic Resonance Imaging ; Muscles ; Physical Examination ; Tendons ; Thumb

PURPOSE: The purpose of this study is to evaluate the clinical results of retrograde intramedullary fixation of metacarpal shaft fractures using two pre-bent Kirschner wires. MATERIALS AND METHODS: Between March 2006 and May 2008, 19 cases (17 patients) of metacarpal shaft fractures were treated with the retrograde intramedullary Kirschner-wire fixation and followed at least one year. The exclusion criteria were thumb metacarpal fractures, comminuted fractures and irreducible metacarpal spiral shaft fracture by closed manipulation. At final follow up all the cases were assessed with total active motion(TAM), rotational deformity, bony union and angular deformity based on the plain radiographes. RESULTS: At the last follow-up, all cases achieved bony union. Five cases showed less than 5degrees of dorsal angular deformity. The average union period was 6.3 weeks (range, 5-9weeks). Fifteen cases (79%) showed excellent results, four cases good results based on TAM. No case showed rotational deformity. Two cases had skin irritation by distal wire end, which was subsided after wire removal. CONCLUSIONS: In patients with a metacarpal shaft fracture, retrograde intramedullary fixation using two pre-bent K-wires can provide satisfactory clinical results.
Bone Wires ; Congenital Abnormalities ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Skin ; Thumb

BACKGROUND: Subungual exostosis is a rare, solitary, benign bony tumor of the distal phalanx. It occurs mainly in the great toe and less frequently in the other toes and fingers. It may cause nail deformity and pain. OBJECTIVE: We wanted to describe the clinical, histopathological and radiological features and the recurrence after treatment of subungual exostosis. METHODS: A total of 12 patients who were diagnosed with subungual exostosis at our hospital from 1997 through 2007 were evaluated. RESULTS: There were seven females and five males. The average age of the patients at the time of surgery was 24.2+/-9.2 years. The mean duration of symptoms was 11+/-6.0 months. All the patients presented with a solitary, fixed, hard exophytic tumor beneath the nail plate. Eight patients (67%) presented with a lesion on the great toe, three patients (25%) with a lesion on the other toes and one patient (8%) with a lesion on the thumb. The histopathology revealed a fibrocartilaginous cap, enchondral ossification and calcification in all the patients and islands of mature trabecular bone in ten patients (83%). The radiographic picture showed a typical pattern of a bony excrescence arising from the dorsal aspect of the distal phalanx. All the patients were treated with surgical excision of the lesion and eleven patients (92%) showed good results. One patient (8%) had a local recurrence and she underwent subsequent excision. No additional local recurrences were observed. CONCLUSION: Subungual exostosis is unfamiliar to most dermatologists, and it can be difficult to diagnose in some cases. When a subungual mass is observed, subungual exostosis should be considered in the differential diagnosis and subsequent radiographic studies along with histologic studies are recommended.
Congenital Abnormalities ; Diagnosis, Differential ; Exostoses ; Female ; Fingers ; Humans ; Islands ; Male ; Nails ; Recurrence ; Thumb ; Toes