Types and aesthetic evaluation of nail deformities after Bilhaut-Clouquet procedure in the treatment of polydactyly deformity

Abstract

Objective To summarize retrospectively the manifestation types of nail deformities after Bilhaut-Cloquet (BC) procedure for polydactyly deformityand its influence on aesthetic evaluation. Methods From January 2005 to December 2015, 84 patients (88 thumbs) were treated with BC. According to the Wassel classification, 3 case was typeⅠ, 20 were type Ⅱ, 12 were type Ⅲ, 33 were type Ⅳ, 6 were type Ⅵ, 10 were type Ⅶ. The shape, width, flatness, semilunar and fold shape of reconstructed nails were observed and classified after the operation. The aesthetic effect of the reconstructed nails was evaluated by the modified Wang-Gao score. Results The follow-up period ranged from 6 to 128 months, with an average of 34.4 months. Among them, abnormal flatness of the reconstructed nails occurred in 51 thumbs (57.95%), nail semilunar deformity in 27 fingers (30.68%), nail fold deformity in 22 fingers (25.00%), abnormal nail width in 16 fingers (18.18%) and abnormal nail shape in 7 fingers (7.95%). According to the modified Wang-Gao score, the score was 2 to 12 points with an average of 9.18 points. Among them, the results were rated as excellent in 58 fingers, good in 23 fingers, fair 5 fingers and poor in 2 fingers, with the excellent and good rate being 92.05%. Conclusion The application of BC procedure for correction of polydactyly deformity has a definite effect on the improvement of finger volume and nail width. The deformities may occur in all the nail structural units requiring reconstruction, and manifestations are diverse, mainly mild deformities. More than three structural unit deformities are the main cause of dissatisfaction of patients or their families, but the incidence is not high. Therefore, BC procedure is still an option for dysplastic polydactyly deformity. Key words: Hand deformities,congenital; Treatment outcome; Bilhaut-Clouquet procedure; Nail deformity