A 16-year-old white male patient with a bone deformity in the distal phalanx of the second finger (index) of the right hand and skin retraction due to a fall of the bicycle suffered when he was 2 years old.
Radiological examination revealed bifid phalanx and dislocation with radial deviation of the distal phalanx.
Clinical examination showed preservation of functional mobility of the distal phalanx despite the existing deformity.
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The surgical approach for correction of the defect included surgical resection of the bifida base of the distal phalanx, performing zetaplasty in the retraction area and alignment and fixation of the distal Kinge number 1 needle.
The patient underwent surgery under general anesthesia, with usual measures of asepsis and antisepsis. An ischemic neu cuff on the right upper limb was used to control operative bleeding.
We performed a 2.5 cm incision in the medial aspect of the index finger and dissection by planes to the distal interphalangeal joint, which allowed us to identify the bone excess located at the base of the distal phalanx.
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On the lateral face of the finger, we performed a second 2.5 cm incision to the base of the distal phalanx on its lateral border, identifying the bony excess and resecting it as well.
Skin hypertrophy retraction was treated with zetaplasty, which allowed us to advance the lateromedial skin and break the force line.
The skin suture was made with 3-0 polyamide and a transarticular Kischner needle number 1 was placed, transfixing the distal and middlephalanges to immobilize the bone structures alignment.
The guja was removed 2 weeks after surgery.
