Abstract

VERGARA AMADOR, Enrique M. Hipoplasia of the thumb: Clinical presentation and reconstruction. rev.fac.med. [online]. 2008, vol.56, n.1, pp.33-42. ISSN 0120-0011.

Background. in the genesis of the partial or total absence of the thumb they are genetic, environmental factors or a combination of both. It is take part of a syndrome or to be isolated and frequently associated with problems of radial longitudinal deficiency of the forearm. Objective. The purpose of this study is mostar the experience, the focus of the processing and the results obtained since the point esthetic and functional view. The most it accepted classification is the proposal by Blauth that helps to determine the forecast and the processing. Materials and methods. it is a work type series of cases in 22 children with hipoplasia of the thumb, with a minimum of 12 months, (average 28 months). In 15 cases there were association of radial dysplasia or another anomaly among them 4 patients with VATER, and the 7 remaining they corresponded to hipoplasia of the thumb as only entity. We carried out tendon transfer, with opening of the first comisure in 2 patients with hipoplasia type II. In 3 patients, with hipoplasia type III A, one carries out corner opening, transfer of the superficial flexor of the 4 finger to correct instability of the articulation MF and opposition of the thumb, and transfer for extension of the thumb. In 17 cases one carries out pollicization of the index. Results. The outcome was evaluated in: non pinch, lateral pinch and fingertip pinch; the grade of opposition like good, minimal and non opposition, and the aesthetic result according to the satisfaction of the parents in bad, regular and good. The five children reconstructed with transfers of tendons and comisure opening had good result. In 17 children with pollicization one patient had a necrosis, of the 16 remaining a good or acceptable result was obtained. Discussion. It is not easy to follow a good system of measure of the functional results. We find that a practical way to evaluate was the clip, opposition and aesthetics. Previous to the surgeries it is required to evaluate alterations hematological or renal. Patient with longitudinal deficiency of the radius they have worse results that the patients that had unique hypoplastic thumb. In general the results were good and they agree with the reports of the literature where they write that the ideal procedure for the reconstruction of the hypoplastic thumb type IIIb, IV and V continue being the pulgarización.

Keywords : abnormalities; thumb; congenital; hereditary; and neonatal diseases and abnormalities.

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