Congenital Clasped Thumb

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Topic updated on 10/05/09 7:17pm
Introduction
  • Characterized by
    • deficient active thumb extension
    • slight limitations of passive extension
Classification

Type
Feature
Operative Treatment
Supple type Due weak or absent EPL or EPB Tendon transfer to EPL
Rigid type Due to hypoplastic extensor tendons, MCP joint contractures, ulnar collateral ligament deficiency, thenar muscle hypplasia, and inadequate first web space skin Procedures include some or all of the following: capsular release, muscle release, FPL Z-lengthening, extensor transfer, opposition transfer, first web space deepening

Treatment
  • Nonoperative
    • treat initially by splinting for 3-6 months
  • Operative
    • indications
      • residual deficiency in active extension
      • significant MCP joint contractures exist
    • procedure based on whether it is supple or rigid (see table above)

 


 

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