삼지골무지 -3례 보고-

초록

Triphalangeal thumb, the first documented case of a thumb with three well-formed phalanges by Dubois in 1826, is characterized by the interposition of an extra phalanx between the two normal phalanges of the thumb. It is a rare congenital deformity with an incidence of about 3% of the upper extremity congenital abnormalities, being equally affected in both sex, and frequently bilateral involvement. Various hypothesis have been advocated to explain the etiology of triphalangeal thumb, however non of them seems to have been sufficiently substantiated. About two-third of patient has family history of inheritance with a very good penetrance. Triphalangeal thumb, due to variable forms of its extraphalanx, appears grossly deformed and is evident that the extralength significantly alters the precision of its handling abilities. We have experienced 3 cases of triphalangeal thumb with various different anatomical feature, respectively, between 1992. 1 to 1994. 1. The selection of corrective operation was governed by the consideration of joint mobility, size of the extraphalanx of each patient. Case Ⅰ was corrected by osteotomy of distal half of proximal phalanx and proxiaml half of extraphalanx with tendon shortening, Case Ⅱ by wedge osteotomy of proximal phalanx, Case Ⅲ by wedge osteotomy of delta phalanx. The postoperative result were satisfactory in the all sense of aesthetic and functional aspects.

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