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Methods for Congenital Thumb Hypoplasia Reconstruction. A Review of the Outcomes for Ten Years of Surgical Treatment

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Department of Hand and Plastic Surgery, Microsurgery Centre of Latvia, Riga East University Hospital, 1000 Riga, Latvia
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Department of Pediatric Surgery, Riga Stradins University, 1000 Riga, Latvia
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Department of Pediatric Surgery, Children Clinical University Hospital, 1000 Riga, Latvia
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(10), 610; https://doi.org/10.3390/medicina55100610
Received: 25 June 2019 / Revised: 30 August 2019 / Accepted: 17 September 2019 / Published: 20 September 2019
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. View Full-Text
Keywords: thumb hypoplasia; congenital hand deformities; pollicization; toe-to-hand transplantation; tendon transfer thumb hypoplasia; congenital hand deformities; pollicization; toe-to-hand transplantation; tendon transfer
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Ozols, D.; Butnere, M.M.; Petersons, A. Methods for Congenital Thumb Hypoplasia Reconstruction. A Review of the Outcomes for Ten Years of Surgical Treatment. Medicina 2019, 55, 610.

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