Abstract
In type 1 separate ossicle, variable surgical procedures for the delta phalanx can be applied, however, excision and tightening of collateral ligament is recommended in most cases. In type 2 and 3 abnormal ossification centers, the treatment can depend on the age of the patient. If the angular deformity is seen before the age of one year and the abnormal ossification center is not clearly visible, close observation and periodic follow-up is reasonable. When the abnormal epiphysis is confirmed on radiography, usually between the age of 1 and 2 years, either partial excision of the epiphysis or intra-epiphyseal osteotomy can be done. When the patient is seen late and the remodeling of the joint is not likely to occur, intraepiphyseal osteotomy is recommended with careful attention to the physis and articular cartilage, because it addresses the anatomic deformity and produce better correction regardless of the IP position.
Highlights
Classification (Figure 1) The classification of the types of angulatory deformity and the variants in ossification of the phalanges of the angled thumbs has not been presented concisely in the literature
If the osteotomy is performed through the epiphysis, angular deformity can be corrected in just the right place from which the deformity originates, and the axis of the IP joint motion becomes perpendicular to the axis of thumb
Summary In type 1 separate ossicle, variable surgical procedures for the delta phalanx can be applied, excision and tightening of collateral ligament is recommended in most cases
Summary
Classification (Figure 1) The classification of the types of angulatory deformity and the variants in ossification of the phalanges of the angled thumbs has not been presented concisely in the literature. Three types of angled thumb from abnormal ossification can be suggested as follows (Figure 1): Type 1. Distal phalanx normal; proximal phalanx normal; location of abnormal ossification center – separate ossicle.
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