Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita

Anbarasan, Amaleswaran; Takagi, Tasuku; Seki, Atsuhito; Takayama, Seiji

doi:10.1177/17531934221101998

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Anbarasan et al (10) reported the results of abductor pollicis brevis rerouting in congenital clasped thumb in arthrogryposis multiplex congenita. They used a polystyrene cone for radiographic assessment of the first web space (9) .…”

Section: Resultsmentioning

confidence: 99%

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Management of Congenital Clasped Thumb in Patients with Distal Arthrogryposis 3 Years Follow-up

Thabet¹,

Aly²,

Mahmoud³

2023

The Egyptian Journal of Hospital Medicine

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Background: Congenital clasped thumb is a deficiency of active extension of the thumb with flexion and adduction deformity after the age of 3 months. In distal arthrogryposis, congenital clasped thumb is characterized by global metacarpo-phalangeal (MCP) joint instability; severe narrow 1st web space and palmar contracture. Objective: The present study aimed to describe patients' characteristics, and the results of treatment of congenital clasped thumb in distal arthrogryposis. Patients and methods: A total of 24 congenital clasped thumbs in 14 patients (9 boys and 5 girls) underwent release of tight first web space structures, Ghani flap, and MCP joint chondrodesis with or without flexor pollicis longus lengthening. There were 10 bilateral and 4 unilateral cases. The mean age of the patients was 4 years old (ranging from 3 to 5). Results: According to the parent parents of the participants, all patients were fulfilled with the thumb function and appearance. Union of the chondrodesis was achieved in 21 thumbs. There was statistically significant improvement of thumb abduction, rotation and opposition. Conclusions: The 1st web space contracture release, Ghani flap and MCP chondrodesis is a good surgical option for management of congenital clasped thumb in distal arthrogryposis.

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Section: Resultsmentioning

confidence: 99%

“…They reported that the rerouted tendon acts as a static tenodesis of the MCP joint in extended position. However, they had 2 cases of MCP instability that required revision by chondrodesis (10) .…”

Section: Resultsmentioning

confidence: 99%

Management of Congenital Clasped Thumb in Patients with Distal Arthrogryposis 3 Years Follow-up

Thabet¹,

Aly²,

Mahmoud³

2023

The Egyptian Journal of Hospital Medicine

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“…The total active movement (TAM) of metacarpophalangeal joints (MPJ) and PIPJ and the extensor lag of PIPJ of the affected fingers were recorded using a goniometer to evaluate camptodactyly. The thumb-to-index finger metacarpal angle (M1M2 angle) and the degree of deviation at the first MPJ (M1P1 angle) were measured with the first web space open to assess the clasped thumb ( 13 ). The PedsQL 4.0 Generic Core Scales were used to assess the quality of life patients.…”

Section: Methodsmentioning

confidence: 99%

A retrospective study on the correction of distal arthrogryposis with a progressive extension brace

Zhou,

Zhang,

Wang

et al. 2024

Front. Pediatr.

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PurposeCamptodactyly, clasped thumbs, and windblown hands are distinctive features of distal arthrogryposis (DA). Current therapeutic interventions often yield suboptimal effects, predisposing patients to relapses and complications. This study explicates a corrective approach involving a progressive extension brace for the management of DA and evaluates its clinical outcomes.MethodsBetween 2015 and 2023, progressive extension braces were used in 32 DA patients, with an average follow-up of 4.8 years. Patients were stratified by age into four groups: 0–1, 1–3, 3–7, and above 7 years. The correction of camptodactyly was assessed based on the total active movement (TAM) of metacarpophalangeal joints (MPJ) and proximal interphalangeal joints (PIPJ), as well as the extensor lag of PIPJ. Clasped thumb correction was evaluated by measuring the thumb-to-index finger metacarpal angle (M1M2 angle) and the degree of deviation at the first MPJ (M1P1 angle). The quality of life for the children was measured using PedsQL 4.0, while parental satisfaction was gauged using the FACE questionnaire.ResultsEarlier intervention with a progressive extension brace yielded superior corrective results. Infants aged 0–1 year and toddlers aged 1–3 years achieved average TAM scores of 152° and 126° after correction; however, patients older than 3 years experienced a significant decrease in TAM with the same treatment. Infants and toddlers with DA showed improvement in the average extensor lag from 46° to 6°. The M1M2 angle increased from an average of 38° to 65°, with the M1P1 angle decreasing from an average of 43° to 5°. After the treatment, average PedsQL scores of 94.7 (parent-reported) and 89.3 (child-reported) were achieved. Among the 32 parents, 24 expressed high satisfaction, 5 expressed moderate satisfaction, and 3 expressed fair satisfaction.ConclusionThe early, progressive, and consistent use of an extension brace significantly improved joint mobility and corrected camptodactyly and clasped thumbs. It can be an effective approach to addressing hand deformities in patients with DA.

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Opponensplasty With Abductor Pollicis Brevis Rerouting for Types II and IIIA Hypoplastic Thumbs

Yamaguchi,

Takagi,

Seki

et al. 2024

The Journal of Hand Surgery

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Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita

Cited by 5 publications

References 21 publications

Management of Congenital Clasped Thumb in Patients with Distal Arthrogryposis 3 Years Follow-up

Management of Congenital Clasped Thumb in Patients with Distal Arthrogryposis 3 Years Follow-up

A retrospective study on the correction of distal arthrogryposis with a progressive extension brace

Opponensplasty With Abductor Pollicis Brevis Rerouting for Types II and IIIA Hypoplastic Thumbs

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