내반 변형을 동반한 족무지 다지증 환자의 특성과 치료

목적: 내반 변형을 동반한 족무지 다지증 환자군의 특성과 치료 결과를 보고하고자 한다. 대상 및 방법: 2003년에서 2010년까지 내반 변형을 동반한 족무지 다지증으로 치료한 환자 5명을 분석하였다. 가족력과 동반 질환, 중족골의 모양, 분기 위치에 대해 조사하였고 잉여지 절제, 국소 피판술, 절골술, 지간 관절 유합술의 술식을 변형의 형태와 나이를 고려하여 시행하였다. 평균 추시 기간은 34개월이었다. 결과: 5명 중 1명은 양측성으로 총 6예의 다지증이 관찰되었고 가족력은 관찰되지 않았다. 동반 질환으로는 congenital anterolateral tibial bowing and polydactyly 3예, 염색체 전위(2 : 13) 및 이와 동반된 잠복고환, 외반 편평족 1예, 소아마비 1예, 족지 합지증 2예, 하지 부동 1예가 있었다. 다지증의 중복은 원위지골에서 5예, 근위지골에서 1예였으며 원위지골에서 중복되는 예 중 한 예는 block proximal phalanx 를 동반하였다. 모든 예에서 잉여지는 제거되었고 족무지의 변형은 교정되었다. 결론: 내반 변형을 동반한 족무지 다지증에서 높은 빈도로 동반 질환이 관찰되었다. 변형의 형태 및 나이에 따라 적절한 수술로 내반 변형을 만족스럽게 교정할 수 있었다. 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 fl ap,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 fi ve 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. KCI Citation Count: 0