Closing Wedge Osteotomy of Abnormal Middle Phalanx for Clinodactyly

Purpose To report a series of clinodactyly patients to report clinical and radiographic outcomes after closing wedge osteotomy and K-wire fixation of abnormal middle phalanges. Methods Twenty-five fingers from 17 patients were included in the study. All patients had more than 25° of angulation and were treated with closing wedge osteotomy. Subjective and objective data with radiographic assessment were compared preoperatively and postoperatively. Results Male gender was predominant in our series (14 of the total 17 patients). Family history was positive for clinodactyly in 4 patients. The appearance of all fingers improved after surgery. Angular deformity was corrected on average from 33° preoperatively to 9° postoperatively. Analysis of radiographs showed deformity correction from 29° preoperatively to 5° postoperatively. Preoperative and postoperative arc of motion measurements were available for 10 patients. Distal interphalangeal joint arc of motion decreased from 84° prior to surgery to 81° after surgery, whereas proximal interphalangeal joint arc of motion was unchanged. Conclusions Closing wedge osteotomy of the abnormal middle phalanx for clinodactyly has provided our patients with adequate correction of the deformity, improved hand function, and has provided high satisfaction for parents. This treatment is recommended for moderate (15° to 30°) and severe (>30°) deformities. Type of study/level of evidence Therapeutic IV.