PMC4623540_01
Illustrations showing preoperative findings. The patient showed impaired pinch function due to severe radial angulations of both thumbs (a, left; b, right). Radiographic images showing proximal delta phalanges in both thumbs (C, left; D, right). The lateral deviation angle3, which is defined as the angle between the longitudinal axis of the metacarpal bone and that of the distal phalanx, was 78  for the left (c) and 54  for the right thumb (d).
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F0001
Rubinstein-Taybi syndrome. Radiographic findings showed proximal delta phalanges and severe radial angulation at the interphalangeal joints (Figures 1c and d ).
Illustrations showing physiolysis of the delta phalanges. Resection of the midzone of the continuous epiphysis along with the underlying physis (a, arrow) and its replacement by a free-fat graft from local tissue (a, arrow head) was performed (b, white arrow).
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F0002
The cavity was filled with a free-fat graft from local tissue in the thumb (Figure 2).
Illustrations showing postoperative findings at 52 months after surgery. The radial angulations of the thumbs were markedly improved (a, left; b, right). According to the radiographic findings at 52 months after surgery, the lateral deviation angle3 was 44  for the left (c) and 30  for the right thumb (d), which indicated a correction of 34  (c) and 24  (d), respectively.
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F0003
Fifty-two months after surgery, satisfactory results were obtained for pinch function and appearance (Figures 3a and b ). According to radiographic measurements, the radial angular deformity was markedly improved in both thumbs, although some deformity remained (Figures 3c and d ).