Abstract
Background and objectives: Congenital thumb hypoplasia is a rare deformity of upper extremity. The incidence for thumb hypoplasia grade II–V is 1:10,000 newborns per year in Latvia. A technique for extensor indicis proprius (EIP) tendon transfer with subperiosteal fixation was developed and used for thumb hypoplasia grades II and IIIa. Pollicization or second-toe-to-hand transplantation with metatarsophalangeal (MTP) joint arthrodesis was used for the reconstruction of hypoplasia grade IIIb–V. The aim of this retrospective cohort study is to evaluate the outcomes for reconstruction techniques used in one surgical center during a ten-year period by one surgeon to evaluate functional and aesthetical outcomes for new techniques. Materials and Methods: In total, 21 patients were operated on during 2007–2017, and 18 of these patients were involved in this study. Long-term follow-up was completed to evaluate the functions and aesthetics of the hands. Results: disabilities of the arm, shoulder and hand (DASH) was 9.35 (8–10.7) for the second-toe-to-hand with MTP joint arthrodesis transplantation method for pollicization method 19.8 (6–26.7), and for the EIP tendon transposition, 14.54 (0.9–56.3). Conclusions: The postoperative functional parameters of congenital hand hypoplasia patients, regardless of the surgical method, are worse than the functional results of healthy patients. The use of the second-toe-to-hand with MTP joint arthrodesis transplantation method provides patients with congenital hand IIIb–V hypoplasia a stable and functional first finger formation. The functional results are comparable to the clinical results of the pollicization method while ensuring the creation of a five-digit hand.
Highlights
Thumb hypoplasia is a rare congenital deformity that constitutes 3.5% of all upper limb congenital deformities
25 reconstructive operations were performed for this group of patients at the MC, and 18 of the patients diagnosed with grade II–V thumb hypoplasia were included in the study
(9–17) months, and six Finger transplants have been performed in children at anage average while for extensor indicis proprius (EIP) tendon transposition it was 38 (11–128) months
Summary
Thumb hypoplasia is a rare congenital deformity that constitutes 3.5% of all upper limb congenital deformities. For the treatment of grade II–IIIa thumb hypoplasia, it is recommended that the first finger be salvaged by stabilizing the metacarpophalangeal (MCP) joint and reconstructing the hypoplastic musculature. The basis for this surgical treatment is to extend the first web space and to stabilize the MCP joint [3]. Pollicization or second-toe-to-hand transplantation with metatarsophalangeal (MTP) joint arthrodesis was used for the reconstruction of hypoplasia grade IIIb–V The aim of this retrospective cohort study is to evaluate the outcomes for reconstruction techniques used in one surgical center during a ten-year period by one surgeon to evaluate functional and aesthetical outcomes for new techniques. Materials and Methods: In total, 21 patients were operated on during 2007–2017, and 18 of these patients were involved in this study
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