Digital Deformities Flashcards
What is post axial polydactyly
Polydactyly of the 5th toe
What is pre axial polydactyly
Polydactyly of the 1st toe
Define polydactyly
Presence of supernumerary digits or metatarsals
Describe the hereditary of polydactyly
Transmitted as an autosomal dominant trait
Most common congenital deformity of the hand and foot
What are the two presentations of polydactyly
- single deformity in the foo (non syndromatic)
- associated with accessory digits in the hand, and there may be other congenital malformations as well (syndromatic)
What is the most common for of polydactyly
post-axial - 5th toe
What is brachymetatarsia
- aberrant condition in which a metatarsal is short and hypoplasicq
Which MT is most commonly affected by brachymetatarsia
4th MT
What happens to the digit in brachymetatarsia
Contracted and cosmetically unacceptable fourth digit
Is brachymetatarsia usually bilateral or unilateral
Bilateral
What are the 7 surgical procedures for surgical management of brachymetatarsia
- Callus distraction (Ilizarov technique)
- Syndactylization
- Bone graft
- Implants
- Auto-implants
- Step-up osteotomies
- Amputation
What is the callous distraction principles based on
The fact that living tissue, when subjected to slow, steady distraction can become metabolically activated in both the biosynthetic and proliferatio
What bone offer advantages for the location of callus distraction
Metaphyseal and diaphyseal bones
Which bone offers the greatest surface area for regeneration and more abundant blood supply for callus distraction
Metaphyseal bone, with its increased diameter and trabecular pattern
What is the most common procedure for brachymetatarsia
Bone graft
What type of osteotomy did Marcinko perform for brachymetatarsia
Z plasty of bone - to lengthen short metatarsal
What are some complications of brachymetatarsia
- Neurovascular compromise
- Overlenthening
- under correction
- malunion
- non-union
- transfer lesion
- recurrence
What is macrodactyly
An increase in the size of the digital elements or structures of the affected part including the theft bones, nerves, subcutaneous, fat nails and skin
Are tendons and blood vessels affected in macrodactyly
No
What type of tissue are involved in macrodactyly
Hypertrophy of plantar and distal tissues
Which are the digits most commonly involved in macrodactyly
1stm 2nd, 3rd
What is the primary treatment for macrodactyly
Surgery
What are the surgical techniques for macrodactyly
- digital amputation (partial versus total)
- ray resection - may be preferred to digital amputation with MT involvement
- digital salvage -
Describe the digital salvage for macrodactyly
- soft tissue procedure to reduce digital bulk
