Functional and Cosmetic Reconstruction of Floating Thumb: A Thumb-preserving Technique

Takagi, Tasuku; Seki, Atsuhito; Takayama, Seiji

doi:10.1097/bth.0000000000000341

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Beyond the evident aesthetic concerns, these anomalies significantly impact hand function and overall limb dexterity. Conventional reconstructive methods have centered around metacarpal augmentation, tendon transfers, and soft tissue reconstruction [13,14]. In a previous study, Liu et al focused specifically on surgical reconstruction for the more severe type IIIB and IV cases using a non-vascularized fourth metatarsal bone graft, which achieved reasonable hand function and cosmesis in 16 patients with 17 type IIIB and IV hypoplastic thumbs over 46 months, despite 2 nonunions [15].…”

Section: Introductionmentioning

confidence: 99%

“…However, these approaches can be limited in cases with severe deficiency, demanding alternative strategies to achieve optimal outcomes. For instance, Takagi et al reported that pollicization of the index finger offers a solution for severely floating thumbs, allowing retention of 5 digits while improving function under the presence of the available fingers in the donor area [13]. Furthermore, proper care, planning, technique selection, adjunct procedures, and rehabilitation are essential for optimal functional results [16].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Shi,

Duan,

2024

Med Sci Monit

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Background:Congenital hypoplasia of the thumb type IV, also known as floating thumb, is a condition in which 2 small phalanges are attached to the hand with a thin skin bridge. Surgical management options for this condition vary from amputation to flap reconstruction. Material/Methods:This retrospective study analyzed 11 infants with congenital hypoplasia of the thumb type IV who underwent surgical reconstruction using a modified vascularized polydactylous hallux flap. The study included 6 male and 5 female infants, aged 6 to 24 months. Functional evaluations and radiographic studies were conducted postoperatively. Results:All 11 patients underwent the complete surgical protocol. Successful vascular and nerve anastomoses were performed during the initial procedure, ensuring sufficient blood supply and neural connectivity to the transferred toes. The second operation showed promising outcomes, including improvements in thumb opposition, grasp strength, and overall function. Postoperative assessments demonstrated satisfactory radiographic alignment and no major complications during the follow-up period. Conclusions:The modified vascularized polydactylous hallux flap reconstruction is a viable surgical option for managing congenital hypoplasia of the thumb type IV in infants. This technique effectively restores thumb opposition, grasp strength, and overall hand function, with satisfactory radiographic alignment and minimal complications.The study findings support the efficacy and safety of this surgical approach in addressing this rare congenital anomaly.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Shi,

Duan,

2024

Med Sci Monit

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Ten Steps for a Successful Hand Surgery Mission Trip – Experiences from Supporting Paediatric Hand in Vietnam and Honduras

TAKAGI,

NGUYEN,

LEVERSEDGE

2024

J Hand Surg Asian-Pac Vol

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Domestic and global access to surgical care for paediatric hand and upper limb conditions is challenged by limited resources, increasing direct and indirect costs of care and a growing number of patients who require specialty care. There are numerous barriers for patients from developing countries to receiving medical care in Japan due to the substantial costs, which include travel, uninsured medical expenses and fees imposed by intermediaries. To address this issue, I realised that I needed to take a more direct approach – by travelling to these countries, not only to provide treatment, but also to teach and train local doctors. By emphasising on the education of local clinicians through the sharing of knowledge and skills, it is possible to expand the timely access to paediatric hand surgery and improve outcomes for children in need. Our mission is rooted in the belief that every nation holds its own unique treasures – its culture, food, beauty and joy – that are worth celebrating and preserving. By fostering sustainable relationships built on mutual respect and understanding, we can make a greater impact; engagement with local surgeons will ultimately elevate the level of care that they can provide in their own communities, through improving core competencies of medical knowledge, technical/surgical skills and resource allocation for simple and complex conditions. This work not only reflects my personal commitment, but also my focus on expanding our team of fellows and strengthening organisational support. We aim to actively pursue these efforts throughout Asia, fostering cross-cultural collaboration and, ultimately, helping to heal the hands and futures of children worldwide. The aim of this review article is to share with readers how we started our mission trips to Vietnam and highlight 10 steps that I feel are critical to a successful mission trip.

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Non-vascularized metatarsal transfer for thumb hypoplasia: a medium- to long-term retrospective study of 41 patients

Iigaya,

Takagi,

Seki

et al. 2024

J Hand Surg Eur Vol

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We retrospectively reviewed 41 Manske type IIIB and IV hypoplastic thumbs reconstructed with non-vascularized fourth metatarsal transfers with a mean age of 3.1 years (range 2–7) at the time of operation. These patients were observed for at least 5 years postoperatively. Of the 41 hands, 13 developed complications: type IV patients had significantly more complications ( p = 0.014) although using an additional cerclage wire for bony fixation significantly reduced the complication rate ( p = 0.045). Of the 31 hands examined with regard to growth, eight exhibited early physeal arrest of bone graft within 5 years postoperatively. The growth rate of the reconstructed first metacarpal bone was significantly lower than that of the second metacarpal bone 10 years after surgery ( p = 0.041). Transfer of the non-vascularized fourth metatarsal remains an alternative for type IIIB and IV hypoplastic thumbs if parents desire to keep a five-fingered hand. Level of evidence: III

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Functional and Cosmetic Reconstruction of Floating Thumb: A Thumb-preserving Technique

Abstract: FIGURE 3. Initial radiograph of the hypoplastic thumb (A), and postoperative radiograph (B).FIGURE 4. Postoperative radiograph of the foot after harvesting the fourth metatarsal bone (A), and postoperative radiograph 6 months after surgery (B).

Cited by 4 publications

References 19 publications

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Surgical Reconstruction of Type IV Hypoplasia of the Thumb (Floating Thumb) in Infants: A Retrospective Analysis of Functional Outcomes and Radiographic Alignment

Ten Steps for a Successful Hand Surgery Mission Trip – Experiences from Supporting Paediatric Hand in Vietnam and Honduras

Non-vascularized metatarsal transfer for thumb hypoplasia: a medium- to long-term retrospective study of 41 patients

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