Apport d’une technique originale de chirurgie conservatrice dans la prise en charge des hypoplasies du pouce de type IIIb : « l’allongement relatif-stabilisation de la colonne du pouce »

Hu, W.; Gasnier, P.; Nen, D. Le; Kerfant, N.; Boloorchi, A.

doi:10.1016/j.anplas.2010.09.014

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…In our study, all of the metatarsal grafts showed postoperation bony incorporation radiologically with no signs of resorption, and the functional outcomes are comparable to other thumb reconstruction methods. 15 There was no deformity or shortening of the toes. Also, there were no problems associated with ambulation, and all toes regained normal range of motion, sensation, and strength.…”

Section: Discussionmentioning

confidence: 93%

Reconstruction of type IIIB thumb hypoplasia using a vascularized hemi-metatarsal composite tissue flap

Fang

Dai

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: The aim of this study was to determine the clinical outcomes of vascularized hemi-metatarsal composite tissue transfer for the reconstruction of type IIIB hypoplastic thumbs. Methods: Twenty-eight patients with type IIIB hypoplastic thumbs treated with vascularized hemi-metatarsal composite tissue transfer were included in this retrospective study with a mean follow-up of 2.4 years. Preoperative digital subtraction angiography was performed to examine the vessel variance. Clinical measures included grip and pinch strength, scar status, and Kapandji thumb opposition score. Subjective Pediatric Outcomes Data Collection Instrument scores and parent satisfaction were also evaluated. Results: Radial arteries were hypoplastic in 82.1% of the cases, and the common palmar digital artery was chosen as the recipient vessel for the tissue transfer. There was no neurovascular complication. The only donor-site complication was a metatarsal fracture that healed with casting. Key pinch and tripod pinch were 29.5% and 45.8% of the normal side, respectively. The mean grip strength was 51.7% of the unaffected side. The mean Kapandji score was 6. The Pediatric Outcomes Data Collection Instrument scores were high for global function; upper extremity function; transfer; and basic mobility, happiness, and comfort. The Vancouver Scar Scale showed an average score of 2.1. All parents were satisfied with the clinical outcomes. Conclusion: Vascularized hemi-metatarsal composite tissue transfer for type IIIB thumb hypoplasia can provide improved subjective outcomes and is a feasible method for the attainment of a five-digit hand. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Section: Discussionmentioning

confidence: 93%

Reconstruction of type IIIB thumb hypoplasia using a vascularized hemi-metatarsal composite tissue flap

Fang

Dai

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…Most studies compared the strength of the operated hand with the normal contralateral hand and reported results between 60 and 70%. Netscher et al [ 26 ], who studied patients with pollicization, reported that the strength of the operated hand was 60% of the contralateral hand, Chow et al [ 27 ], who reconstructed the hypoplastic thumb with a hemilongitudinal metatarsal transfer, reported 61%, and Hu et al [ 28 ], who stabilized the hypoplastic thumb by creating a pseudoarthrosis, reported 67%. Patients treated with pollicization in a cohort studied by Vekris et al [ 29 ] had slightly more strength than the contralateral side with 76%, while patients treated with pollicization in a study by Staines et al [ 30 ] developed significantly less strength in the operated hand with an average of 35%.…”

Section: Discussionmentioning

confidence: 99%

An Alternative Treatment Option for Blauth III B Thumb Hypoplasia—Thumb Stabilization with Iliac Crest Bone Graft and Intermetacarpal Arthrodesis

Oeckenpöhler,

Langer,

Wichmann

et al. 2023

JCM

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Thumb hypoplasia modified Blauth III B is usually treated by pollicization or, less commonly, by toe transfer. Both procedures always result in the resection of a body part, but with good cosmesis and acceptable function. We describe an intermetacarpal I/II arthrodesis with autologous bone graft augmentation to lengthen and stabilize the loose thumb. Clinical data were collected from nine patients, median age at surgery 3 years 8 months, with more than 7 years of follow-up. The results showed a grip strength on the Jamar dynamometer of approximately 61% of the unoperated hand. The Quick-DASH score was 11. The reconstructed thumb was 0.8 cm thinner and 1.9 cm shorter. Overall satisfaction on the VAS, with an average of 1.5 out of 10, is excellent with a partially usable thumb on a hand with five rays. The described procedure is a reliable treatment option with satisfactory results. In addition, none of the patients lost pincer grip between the second and third digit, but their thumb gained new function. Especially in environments where physical integrity has a high value, thumb construction instead of replacement could be considered.

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“…[9] The goal of treating such abnormality is to provide the child with a stable and functional thumb unit, as well as to improve cosmesis. [10] In spite of multiple studies have suggested better functional outcome of pollicization than what various bone flap based reconstructions could achieve, [11,12] parents’ objections to amputation are strong in China, as finger mutilation is associated with criminality in the afterlife by the social perceptions. Speaking from our experiences, most parents would not hesitate to trade certain degree of functional inadequacy for a whole-looking hand.…”

Section: Discussionmentioning

confidence: 99%

Reversed vascularized second metatarsal flap for reconstruction of Manske type IIIB and IV thumb hypoplasia with reduced donor site morbidity

Tong

et al. 2019

Chinese Medical Journal

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Apport d’une technique originale de chirurgie conservatrice dans la prise en charge des hypoplasies du pouce de type IIIb : « l’allongement relatif-stabilisation de la colonne du pouce »

Cited by 7 publications

References 20 publications

Reconstruction of type IIIB thumb hypoplasia using a vascularized hemi-metatarsal composite tissue flap

Reconstruction of type IIIB thumb hypoplasia using a vascularized hemi-metatarsal composite tissue flap

An Alternative Treatment Option for Blauth III B Thumb Hypoplasia—Thumb Stabilization with Iliac Crest Bone Graft and Intermetacarpal Arthrodesis

Reversed vascularized second metatarsal flap for reconstruction of Manske type IIIB and IV thumb hypoplasia with reduced donor site morbidity

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