Patient Characteristics and Treatment of Hallux Polydactyly Associated with Varus Deformity

Du Hyun Ro; Moon Sang Chung; Goo Hyun Baek; Hyuk Jin Lee; Cheol Ho Song; Hyoungmin Kim; Hyun Sik Gong

doi:10.4055/jkoa.2012.47.1.1

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Ro, Chung, Baek, Lee, Song, Kim, and Gong: Patient Characteristics and Treatment of Hallux Polydactyly Associated with Varus Deformity

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(1): 1-8.

Published online: 29 February 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.1.1

Patient Characteristics and Treatment of Hallux Polydactyly Associated with Varus Deformity

Du Hyun Ro, M.D., Moon Sang Chung, M.D., Goo Hyun Baek, M.D., Hyuk Jin Lee, M.D., Cheol Ho Song, M.D., Hyoungmin Kim, M.D., Hyun Sik Gong, M.D.

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Correspondence to: Hyun Sik Gong, M.D. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707, Korea. TEL: +82-31-787-7198, FAX: +82-31-787-4056, hsgong@snu.ac.kr

Received 5 April 2011 Revised 29 May 2011 Accepted 14 July 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate patient characteristics such as deformity type, associated disease, and family history, and results of treatment of pre-axial polydactyly with hallux varus deformity.

Materials and Methods

We carried out a retrospective study of 5 patients who presented with preaxial polydactyly with hallux varus deformity, and were treated between 2003 and 2010 at the authors' hospital. Surgeries including extra digit excision, local flap, osteotomy, and interphalangeal joint fusion were performed taking into consideration the deformity types and patient's age. Family history, associated disease, and types of duplication were assessed, and the outcomes of surgery were evaluated with radiographs and appearances of foot. The mean follow-up period was 34 months.

Results

All 5 patients had one or more associated anomalies such as congenital anterolateral tibial bowing and polydactyly in three, translocation of chromosome 2 : 13 associated with cryptorchidism in one, pes planovalgus in one, residual poliomyelitis in one, syndactyly of the foot in two, and leg length discrepancy in one patient. There was no family history of hallux polydactyly in any of the cases. All five patients had duplication of the distal phalanx and one of them had a blocked proximal phalanx. The extra digit was completely removed and the varus deformity was corrected in all cases.

Conclusion

There was a high incidence of associated diseases in patients with hallux polydactyly and varus deformity. Deformity correction could be obtained by surgeries chosen according to the individual deformity type and patient age.

Keywords: polydactyly, hallux varus, associated disease

Figures and Tables

Figure 1

Anteroposterior radiograph of the lower legs demonstrates anterolateral bowing of the left tibia.

Figure 2

Anteroposterior radiograph of the foot shows duplication of the distal phalanx of the hallux.

Figure 3

Photograph showing the hallux polydactyly and varus deformity. A proximally based dorsal skin flap is shown.

Figure 4

A distally based medial skin flap is designed and the skin flap is defatted.

Figure 5

Postoperative radiograph demonstrates metatarsal osteotomy and fixation with K-wires.

Figure 6

Immediate postoperative photograph the foot.

Figure 7

The proximally based dorsal skin flap is translocated into the medial skin defect which had occurred after excision of the extradigit and correction of the varus.

Figure 8

Photograph taken one and a half year postoperatively shows satisfactory correction of the deformity.

Table 1

Patient Characteristics

op., operation; F/U, follow up period; M, male. ^*CATBP, congenital anterolateral tibial bowing and polydactyly.

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