A Case of a 5-Year-Old Boy with a Blauth Type IIIB Hypoplastic Thumb Reconstructed with a Nonvascularized, Hemilongitudinal Metatarsal Transfer

Nakada, Mika; Tada, Kazuhiro; Nakajima, Tadahiro; Matsuta, Masashi; Yokogawa, Noriaki

doi:10.1155/2018/8205285

Cited by 6 publications

(8 citation statements)

References 11 publications

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“…Clinical presentation ranges from minimal underdevelopment of the thumb (Grade I) to a completely absent thumb (Grade V) (Table 1 ). 9 …”

Section: Discussionmentioning

confidence: 99%

“…6,7 Both sexes are equally affected by the condition. 8,9 Many classifications have graded congenital thumb hypoplasia and theses classifications aid in surgical decisionmaking. It was initially categorized by Müller, but Blauth's classification (and BuckGramcko's revision) is the one that is most frequently used today.…”

Section: Investigations and Treatmentmentioning

confidence: 99%

“…8 Clinical presentation ranges from minimal underdevelopment of the thumb (Grade I) to a completely absent thumb (Grade V) (Table 1). 9 Type I thumb hypoplasia in both hands is extremely rare, with an estimated incidence of less than 1 in a million births. The occurrence of Type I hypoplasia in both hands and feet is even rarer, with only a few reported cases in the medical literature.…”

Section: Investigations and Treatmentmentioning

confidence: 99%

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A 23‐year‐old patient with bilateral hypoplastic thumbs and toes: A case report

Hamsho,

Sleiay,

Alaswad

et al. 2024

Clinical Case Reports

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Key Clinical MessageHowever, it is noteworthy that certain patients with minor functional limitations in their hand may have experienced undiagnosed thumb hypoplasia during their childhood years. These individuals may have successfully adapted to their condition without seeking medical intervention and may express a preference for nonintervention (as in this case).AbstractThumb hypoplasia is a congenital underdevelopment of the thumb, accounting for 5%–15% of congenital hand disorders. It occurs equally among both genders and can affect both thumbs. The condition is categorized using Blauth's classification with Type I being the mildest form. We report a 23‐year‐old Syrian male presented with a bilateral restriction in opposition movement when using a pen or razor. Clinical examination and x‐ray imaging revealed a bilateral Type I hypoplastic thumb with bilateral minimal hypoplasia of the toes. Despite the surgical treatment options available, the patient opted not to undergo surgery due to his adaptation to his condition. Hypoplastic thumb Type I is a congenital condition characterized by underdevelopment of the thumb. Bilateral thumb hypoplasia with toes hypoplasia is extremely rare. A full systemic evaluation should be done due to its associations with other syndromic manifestations and treatment options are discussed concerning the best functional outcomes and patient preferences.

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“…Clinical presentation ranges from minimal underdevelopment of the thumb (Grade I) to a completely absent thumb (Grade V) (Table 1 ). 9 …”

Section: Discussionmentioning

confidence: 99%

Section: Investigations and Treatmentmentioning

confidence: 99%

Section: Investigations and Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

A 23‐year‐old patient with bilateral hypoplastic thumbs and toes: A case report

Hamsho,

Sleiay,

Alaswad

et al. 2024

Clinical Case Reports

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“…The benefit for these methods is the possibility to create a five-digit hand without toe count limitations, but donor side morbidity must be considered. Poor functionality of the reconstructed thumb has been reported by Nakada et al [31]. This method is commonly used in Asian countries.…”

Section: Methodsmentioning

confidence: 97%

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

2019

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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.

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“…In the literature, few reconstructive surgeries are presented that are aimed at increasing the stability of the hypoplastic thumb, where hypermobility and instability are the leading causes of dysfunction. [9][10][11][16][17][18][19][20][21][22][23]…”

Section: Introductionmentioning

confidence: 99%

Stabilization of the hypoplastic thumb type Blauth IIIB using a non-vascularized proximal interphalangeal joint from the toe as an alternative reconstruction when pollicization is not accepted: Description of the surgical technique

Górecki,

Czarnecki,

Romanowski

2024

Adv Clin Exp Med

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Background. A Blauth IIIB hypoplastic thumb is a significant functional and cosmetic problem for the developing hand in children. The gold standard in treatment is amputation and index pollicization. Despite the good functional results, some parents do not consent to the operation, mainly for cosmetic reasons.Objectives. The aim is to present a detailed description and features of the technique used in our department for stabilization of a hypoplastic thumb type Blauth IIIB with a non-vascularized proximal interphalangeal joint from the toe. This is the first description of this surgery for this kind of congenital defect, together with the largest group of patients analyzed compared to alternative techniques described in the literature. Materials and methods.Sixteen patients were included in the analysis. The mean age was 3 years (standard deviation (SD) ±2). In most cases, it was a unilateral and isolated defect. We described the surgical technique and postoperative management in detail and assessed intraoperative factors such as donor selection, operative time, technical problems, stabilization time, complication rate, and reoperations. Appropriate statistics were performed.Results. Most often, the graft was taken from the 3 rd toe. The average operation time was 59 ±17.5 min. No technical problems were found during the surgery. The Kirschner wire was removed after an average of 6.5 weeks. The complication rate was 25%, which included the destabilization of Kirschner wires or graft non-union, but it decreased to 6% after reoperation. Five patients underwent tendon transfers. Conclusions.The presented technique is based on principles such as vascularized metatarsophalangeal joint transplants. It may be an option for stabilizing a hypoplastic thumb if parents do not consent to pollicization. Having microsurgical skills is unnecessary. The operation and anesthesia times are significantly shorter, resulting in less burden on the child's body. The study will continue assessing long-term postoperative functions and the comparison to pollicization.

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A Case of a 5-Year-Old Boy with a Blauth Type IIIB Hypoplastic Thumb Reconstructed with a Nonvascularized, Hemilongitudinal Metatarsal Transfer

Cited by 6 publications

References 11 publications

A 23‐year‐old patient with bilateral hypoplastic thumbs and toes: A case report

A 23‐year‐old patient with bilateral hypoplastic thumbs and toes: A case report

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

Stabilization of the hypoplastic thumb type Blauth IIIB using a non-vascularized proximal interphalangeal joint from the toe as an alternative reconstruction when pollicization is not accepted: Description of the surgical technique

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