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Reconstruction of a Congenital Hypoplastic Thumb with Use of a Free Vascularized Metatarsophalangeal Joint*
MINORU SHIBATA, M.D.†; TAKAE YOSHIZU, M.D.‡; TOSHIAKI SEKI, M.D.§; MICHIKO GOTO, O.T.†; HIDEHIKO SAITO, M.D.#; TATSUYA TAJIMA, M.D.**, NIIGATA, JAPAN
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Investigation performed at the Division of Plastic and Recontructive Surgery, Niigata University Hospital, Niigata
J Bone Joint Surg Am, 1998 Oct 01;80(10):1469-76
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Abstract

Reconstruction of a Blauth type-IIIB hypoplastic thumb with use of a free vascularized metatarsophalangeal joint was performed in four patients (four hands). Several tendon transfers also were performed, either primarily or secondarily, to mobilize the reconstructed thumb. Three patients (three hands) were followed for at least two years after the reconstruction; the results for these three patients were compared with those for four patients (six hands) who had been managed with pollicization of the index finger because of a similar deformity of the thumb.The patients were evaluated with regard to grip strength, key-pinch strength, and the range of motion of the joints of the thumb in the operatively treated and contralateral hands as well as with regard to skill in performing activities of daily living as assessed with use of the Kobe hand-function test. Although the appearance of the thumb was closer to normal in the group that had had the pollicization procedure, total function of the hand and grip strength were greater in the group that had had the transfer procedure.We believe that reconstruction of an unstable hypoplastic (Blauth type-IIIB) thumb with use of a vascularized metatarsophalangeal joint is an acceptable alternative to pollicization of the index finger.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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