Journal articles: 'Thumb'

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Herbert, R. D., and S. C. Gandevia. "Muscle activation in unilateral and bilateral efforts assessed by motor nerve and cortical stimulation." Journal of Applied Physiology 80, no. 4 (April 1, 1996): 1351–56. http://dx.doi.org/10.1152/jappl.1996.80.4.1351.

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Voluntary muscle activation was measured with twitch interpolation in 11 subjects during attempted maximal voluntary contractions of the right thumb adductor muscles either in isolation (“thumb alone”) or as the subjects simultaneously performed maximal voluntary contractions of the left thumb adductors or left elbow flexors (“both thumbs” or “thumb and elbow”, respectively). During thumb alone contractions, median voluntary activation of the right thumb adductors was 90.3%, and subjects fully activated the thumb adductors on 22% of all contractions. Transcranial magnetic stimulation of the cortex during maximal voluntary efforts produced small twitchlike force increases, suggesting that at least part of the voluntary activation failure was attributable to suboptimal corticospinal drive. Maximal voluntary force produced by the right thumb adductors in the three conditions differed by < 2% (P = 0.21), and the ability to activate the thumb adductors in the both thumbs condition was only marginally less than during thumb alone contractions (median 88.6%; P = 0.004).Thus subjects are usually unable to fully activate their thumb adductors with maximal voluntary efforts, and simultaneous maximal contractions of contralateral muscle groups have little effect on this ability.

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KADIYALA, R. K., R. H. GELBERMAN, and B. KWON. "Basal Joint Arthrosis." Journal of Hand Surgery 21, no. 2 (April 1996): 177–81. http://dx.doi.org/10.1016/s0266-7681(96)80093-3.

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A radiographic method was developed, the trapezial space ratio, for assessing the space occupied by the trapezium (a space defined by the distal scaphoid and thumb metacarpal base divided by the thumb proximal phalanx). This method was applied to 100 normal thumb radiographs and to the radiographs of 15 patients with symptomatic degenerative arthrosis of the thumb basal joint before and after operative treatment with ligamentous reconstruction and tendon interposition arthroplasty. The trapezial space ratio averaged 0.476 ± 0.033 for radiographs of normal thumbs, 0.372 ± 0.084 for the pre-operative radiographs of thumbs with symptomatic basal joint arthrosis, and 0.270 ± 0.078 for the radiographs of thumbs following basal joint arthroplasty. A significant reduction in the trapezial space ratio was noted when values from arthritic thumbs were compared to those of normal thumbs (22%; P<0.0001). A further reduction in the trapezial space ratio was noted when post-operative values were compared to pre-operative ones (27%; P< 0.0002). Comparing post-operative trapezial space ratio values to values obtained in normal thumbs, a reduction of 43% was found in those thumbs treated operatively. These finding indicate that the trapezial space is reduced significantly in thumbs with severe degenerative arthrosis compared to normal thumbs and that ligament reconstruction tendon interposition arthroplasty is not entirely successful in either restoring or maintaining the length of the thumb ray.

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Zhou, Tong, Xu Zhang, Xiaofei Yu, Yanbin Bai, Huan Chen, Jia Li, Hongjie Li, and Yadong Yu. "Modified method for reconstruction of thumb abduction function in children undergoing surgical treatment of thumb duplication." Journal of Children's Orthopaedics 15, no. 2 (April 19, 2021): 97–105. http://dx.doi.org/10.1302/1863-2548.15.200197.

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Purpose This study was performed to evaluate a modified method of reconstructing the thumb abduction function in children undergoing surgical treatment of thumb duplication. Methods This retrospective study included 33 children (38 thumbs) with Wassel type III to VII thumb duplication who underwent excision of the polydactylism and osteotomy of the preserved thumb. Among them, 16 children (19 thumbs) underwent reconstruction of the attachment of the articular capsule and collateral ligament of the metacarpophalangeal joint, abductor pollicis brevis and flexor pollicis brevis by the anchor technique (Group A), while 17 children (19 thumbs) underwent suturing the attachment of the above-mentioned soft tissues to the periosteum (Group B). All children were followed up for six years after surgery. The appearance, function and joint stability of the preserved thumb were compared between the two groups; the bone alignment and development were observed. Results The deformity rate of preserved thumbs and the positive rate of lateral stress test were significantly lower in Group A than B (p < 0.05). The modified Tada score and the distance of first web were significantly higher in Group A than B (p < 0.05). Flexion, extension, adduction, abduction and palmar movement of the thumbs were good; bone alignment and development were good and no osteophyte or anchor shadow was left in the preserved thumbs in Group A. Conclusion Reconstruction of the abduction function using the anchor technique is effective in children undergoing surgical treatment for Wassel type III to VII thumb duplication and it may be superior to the conventional technique. Level of evidence III

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REIGSTAD, A., and K. R. HETLAND. "Cross Thumb Transfer." Journal of Hand Surgery 18, no. 6 (December 1993): 778–80. http://dx.doi.org/10.1016/0266-7681(93)90244-a.

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Thumb reconstruction following amputation was accomplished by microvascular transfer of the thumb from the contralateral paralyzed hand in two cases. The appearance and function of the transferred thumbs were excellent and no problem was seen in the donor hand.

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Zuidam, J. M., R. W. Selles, and S. E. R. Hovius. "Thumb strength in all types of triphalangeal thumb." Journal of Hand Surgery (European Volume) 37, no. 8 (February 22, 2012): 751–54. http://dx.doi.org/10.1177/1753193412438195.

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Strength is regarded as normal in patients with an opposable triphalangeal thumb. Our clinical impression is, however, that intrinsic musculature is probably affected in all forms of triphalangeal thumb. Therefore, we established the strength of 38 thumbs in patients with a triphalangeal thumb. Patients were excluded if the intrinsic musculature was enhanced or if osteotomies of the first metacarpal were performed. On average, strength of all thumb functions was significantly diminished, up to 63% for opposition strength. Strength of the power grip was on average 70%. As shown in this study, strength of the musculature of the thumb is affected in all types of triphalangeal thumb. Although strength of the thumb is diminished, in the investigated group it is apparently sufficient in daily life, as these individuals did not seek surgical enhancement. However, reconstructive procedures that enhance intrinsic musculature must be considered in all types of triphalangeal thumb.

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Wirth, Johanna, and Eva-Maria Baur. "Treatment of Severe Ulnar Instability of the MCP Joint Improves Function in LRTI Arthroplasty for Osteoarthritis of the Thumb CMC Joint." Journal of Wrist Surgery 09, no. 02 (December 31, 2019): 105–15. http://dx.doi.org/10.1055/s-0039-1697650.

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Abstract Background Comorbidity in the metacarpophalangeal joint (MCPj) of the thumb, i.e., hyperextension or ulnar collateral instability, could affect the outcome of arthroplasty in the thumb carpometacarpal joint (CMCj). Objective In a retrospective study, we evaluated the effect of arthrodesis of the MCPj for thumbs with unstable MCPj and simultaneous ligament reconstruction tendon interposition (LRTI) arthroplasty for the CMCj in terms of strength, function, and patient satisfaction. Patients and Methods A total of 69 thumbs treated with a LRTI arthroplasty of the CMCj were included. In 14 of those cases, an arthrodesis of the MCPj was performed as well. In 12 thumbs, both procedures were done simultaneously; in one case MCPj arthrodesis followed LRTI arthroplasty, whereas one patient already had MCPj arthrodesis at time of LRTI arthroplasty. Those 14 thumbs were compared with the control group of 55 thumbs who had only undergone LRTI. At a mean follow-up of 4 to 5 years (mean 54 [10–124] months) postoperative assessments included range of motion (ROM) of the CMC, MCP, and interphalangeal (IP) joint of the thumb, as well as any instability of the MCPj. Pinch and grip strength were examined, also the visual analogue scale (VAS), patient satisfaction, QuickDASH, PRWE-Thumb, and the Kapandji's Opposition Score. Radiologically, proximalization of the first metacarpal bone was measured. Student's t-test was used to determine significance, p < 0.05 was considered significant. Results Additional arthrodesis of the MCPj provided no significant difference of function in thumbs that only had a hyperextension-instability. However, in thumbs with marked ulnar instability, stronger pinch-grip was obtained with arthrodesis, compared with only LRTI. Conclusion In patients with advanced painful thumb CMCj osteoarthritis, we recommend (simultaneous) arthrodesis of the MCPj, to allow a stable thumb grip if there is additional marked ulnar collateral ligament instability. Level of Evidence This is a Level III, retrospective comparative study.

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Westgarth, David. "Thumbs down to thumb sucking." BDJ In Practice 33, no. 1 (January 2020): 24–25. http://dx.doi.org/10.1038/s41404-019-0273-3.

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Tonogai, Ichiro, Yoshitaka Hamada, and Naohito Hibino. "EVALUATION OF THE FIRST METACARPAL PROXIMAL FACET INCLINATION AS A PROGNOSTIC PREDICTOR FOLLOWING ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 18, no. 01 (January 2013): 69–72. http://dx.doi.org/10.1142/s0218810413500135.

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We have retrospectively reviewed 17 thumbs in 16 patients with osteoarthritis of the thumb carpometacarpal joints, for which arthroplasty was performed using Kaarela's method. Postoperatively, three thumbs in two patients had poor outcomes; both patients had a sharp slope of the base of the first metacarpal. Serial radiographic measurements suggested that this sharp slope affected the adducted position of the first metacarpal, and led to the appearance of a metacarpophalangeal joint hyperextension deformity of the thumb. This radiological finding could be a prognostic predictor after surgery for osteoarthritis of the thumb carpometacarpal joint.

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Zuidam, J. M., E. E. C. Dees, R. W. Selles, and S. E. R. Hovius. "Implications for Treatment of Variations in Length of the First Metacarpal in Different Types of Triphalangeal Thumbs." Journal of Hand Surgery (European Volume) 35, no. 1 (January 2010): 65–69. http://dx.doi.org/10.1177/1753193408095881.

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Abnormal function in the triphalangeal thumb is partly due to its extra length, which is due not only to the extra phalanx, but also to differences in the length of the first metacarpal. This study investigated whether the additional length of the first metacarpal is influenced by the growth plate location alone, or also by the type of triphalangeal thumb. Fifty-nine hands in 37 patients with triphalangeal thumbs were examined for thumb type (delta 31, trapezoid nine and full type 19), growth plate location and relative length of the first metacarpal. The first metacarpals in all three types of triphalangeal thumbs were significantly longer than in the normal population. The length of the first metacarpal was related to the site of the growth plate. The type of triphalangeal thumb did not affect the length. These findings suggest that a corrective procedure on the first metacarpal should be considered in all types of triphalangeal thumbs.

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Johnstone, Bruce R., L. J. Currie, Edmund W. Ek, Daniel J. Wilks, David B. McCombe, and Christopher J. Coombs. "The “Trigger” Thumb Locked in Extension – An Unusual Presentation of a Common Paediatric Condition." Journal of Hand Surgery (Asian-Pacific Volume) 21, no. 02 (May 3, 2016): 234–38. http://dx.doi.org/10.1142/s2424835516500247.

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Background: We report a variant of paediatric trigger thumb which is locked in extension rather than flexion. Methods: Eleven children with 14 trigger thumbs (three bilateral) locked in extension were reviewed retrospectively over a 12-year period. The number of flexed trigger thumbs encountered over this period was established from the operating room database. Results: All children were treated with release of the A1 pulley. Nine children achieved a full range of motion at the interphalangeal joint. One child with bilateral extended trigger thumbs required bilateral dorsal capsulotomy and another child developed temporary mild triggering in flexion. Conclusions: Approximately 1% of trigger thumbs treated operatively at this institution presented as the extended variant. Trigger thumb locked in extension should be considered in a child presenting with inability to flex the thumb.

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LIN, S.-C., T.-H. HUANG, H.-Y. HSU, C.-J. LIN, and H.-Y. CHIU. "A Simple Splinting Method for Correction of Supple Congenital Clasped Thumbs in Infants." Journal of Hand Surgery 24, no. 5 (October 1999): 612–14. http://dx.doi.org/10.1054/jhsb.1999.0203.

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A splint has been designed to correct the congenital clasped thumb. It is like a short opponens splint that can keep the thumb in a position of abduction and extension without limiting wrist movement. The application of the splint was easy and adjustment for fit could be made at each visit if necessary. The device has been used in 11 infant patients (17 thumbs) with congenital clasped thumb of the supple type. The functional results were excellent in 15 of 17 thumbs, and the other two were good according to the grading system of Weckesser et al. (1968) .

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Yu, Hayeon, Yunha Park, and Joonho Chang. "Which Thumb, the Left or Right, Touches the Letter Keys on a Smartphone QWERTY Soft Keyboard during Two-Thumb Key Entry?" Applied Sciences 13, no. 22 (November 16, 2023): 12417. http://dx.doi.org/10.3390/app132212417.

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This study aims to observe which thumb, the left or right, is used for keystrokes and examine the patterns during two-thumb key entry on a smartphone QWERTY soft keyboard. A total of 36 college students, including 18 left-handed and 18 right-handed, were recruited for testing, and they had 9.7 years of smartphone use experience on average. A smartphone application was implemented, and whether the left or right thumb was used for touch interactions was recorded for each of the 26 letter keys. As a result, it was found that there were slightly more letter keys that were statistically more often tapped by the left thumb during the two-thumb key entry on the QWERTY soft keyboard, regardless of the participant’s handedness. In addition, all the letter keys were touched statistically more often with the relatively closer one of both thumbs, except for the letter keys G and V in the center. It seemed that the distance between keys and thumbs was regarded as the most important factor influencing the thumb choice for keystrokes, followed by the habituated experience of using physical QWERTY keyboards.

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Werner, Brian C., Nicole S. Belkin, Steve Kennelly, Leigh Weiss, Ronnie P. Barnes, Scott A. Rodeo, Russell F. Warren, and Robert N. Hotchkiss. "Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb, Including Simultaneous Combined Thumb Ulnar and Radial Collateral Ligament Injuries, in National Football League Athletes." American Journal of Sports Medicine 45, no. 1 (October 1, 2016): 195–200. http://dx.doi.org/10.1177/0363546516660979.

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Background: Thumb collateral ligament injuries occur frequently in the National Football League (NFL). In the general population or in recreational athletes, pure metacarpophalangeal (MCP) abduction or adduction mechanisms yield isolated ulnar collateral ligament (UCL) and radial collateral ligament (RCL) tears, respectively, while NFL athletes may sustain combined mechanism injury patterns. Purpose: To evaluate the incidence of simultaneous combined thumb UCL and RCL tears among all thumb MCP collateral ligament injuries in NFL athletes on a single team. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all thumb injuries on a single NFL team from 1991 to 2014 was performed. All players with a thumb MCP collateral ligament injury were included. Collateral ligament injuries were confirmed by review of both physical examination findings and magnetic resonance imaging. Player demographics, surgical details, and return-to-play data were obtained from the team electronic medical record and surgeons’ records. Results: A total of 36 thumbs in 32 NFL players were included in the study, yielding an incidence of 1.6 thumb MCP collateral ligament injuries per year on a single NFL team. Of these, 9 thumbs (25%) had a simultaneous combined UCL and RCL tear injury pattern confirmed on both physical examination and MRI. The remaining 27 thumbs (75%) were isolated UCL injuries. All combined UCL/RCL injuries required surgery due to dysfunction from instability; 63.0% of isolated UCL injuries required surgical repair ( P = .032) due to continued pain and dysfunction from instability. Repair, when required, was delayed until the end of the season. All players with combined UCL/RCL injuries and isolated UCL injuries returned to play professional football the following season. Conclusion: Simultaneous combined thumb UCL and RCL tear is a previously undescribed injury pattern that occurred in 25% of thumb MCP collateral ligament injuries on a single NFL team over a 23-year period. All players with combined thumb UCL/RCL injuries required surgical repair, which was significantly higher compared with players with isolated UCL injuries. Team physicians and hand surgeons treating elite football players with suspected thumb collateral ligament injuries should examine for RCL and UCL instability and consider MRI if any concern exists for a combined ligament injury pattern, as this injury is likely frequently missed.

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JENKINS, M., H. B. BAMBERGER, L. BLACK, and R. NOWINSKI. "Thumb Joint Flexion." Journal of Hand Surgery 23, no. 6 (December 1998): 796–97. http://dx.doi.org/10.1016/s0266-7681(98)80100-9.

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The purpose of this study was to measure the amount of active flexion from a neutral position in normal thumb metacarpophalangeal and interphalangeal joints and compare the results with previously published reports. One hundred and nineteen subjects (238 thumbs) volunteered to have active flexion of the metacarpophalangeal (MP) and interphalangeal (IP) joints of the thumb measured with a computerized Greenleaf goniometer by a certified hand therapist. The mean MP flexion was 59° and IP flexion was 67°. The results of this study suggest that the accepted normal values of thumb flexion should be reconsidered, particularly as a guide for determining impairment.

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MENNEN, U. "Triplication of the Thumb." Journal of Hand Surgery 24, no. 2 (April 1999): 253–54. http://dx.doi.org/10.1054/jhsb.1998.0192.

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A child with triplication of the thumb is presented. Each thumb was fully developed with neurovascular bundles, flexor and extensor tendons. Although all three thumbs were triphalangeal, they shared a common metacarpal and two shared a common proximal phalanx. Since this anomaly does not fit in the existing accepted Wassel (1969) classification, a new category is suggested.

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Thomson, Hugh G., and Douglas Grace. "Congenital adducted thumb: Role of the index transposition flap." Canadian Journal of Plastic Surgery 4, no. 2 (July 1996): 1–8. http://dx.doi.org/10.1177/229255039600400202.

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This study examines the results of a large length:width ratio transposition flap used for the correction of the congenitally adducted thumb. The flap is elevated from the radial side of the index finger and transposed into the palm parallel to the thenar crease. Long term analysis of flap results included the disappearance of a transverse palmar white line; length:width ratios; angle of abduction of thumb; sensation of flap; and functional assessment of thumb and index finger. There were 49 adducted thumbs operated on and 26 flaps were clinically examined with an average length:width ratio of 3.5:1, with some flaps having ratios of up to 6:1. All adducted thumbs were adequately released with no complications encountered.

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MALIK, A. K., T. MORRIS, D. CHOU, E. SORENE, and E. TAYLOR. "Clinical Testing of Ulnar Collateral Ligament Injuries of the Thumb." Journal of Hand Surgery (European Volume) 34, no. 3 (April 6, 2009): 363–66. http://dx.doi.org/10.1177/1753193408100957.

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The diagnosis of complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal (MP) joint depends on demonstration of excessive laxity of the ligament, but there is controversy on whether laxity greater than a certain cut-off value or laxity greater than the opposite thumb is the criterion for diagnosis. We examined 200 thumbs of 100 normal individuals in extension and in 30° of flexion. In 34% of subjects there was a difference of 10° or more between right and left thumbs in extension, and 12% had a difference of at least 15°. In flexion, 22% of thumbs differed by 10° or more and 3% by 15° or more. Comparison with the uninjured contralateral thumb is unreliable in many individuals. We recommend the lack of a definite end point on stress examination as indicating complete rupture of the ulnar collateral ligament.

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MOON, W. N., S. W. SUH, and I. C. KIM. "Trigger Digits in Children." Journal of Hand Surgery 26, no. 1 (February 2001): 11–12. http://dx.doi.org/10.1054/jhsb.2000.0417.

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Seven thousand, seven hundred newborn children were examined prospectively to determine the congenital incidence of trigger thumb and finger. No cases were found. The case histories of 43 trigger digit cases (35 trigger thumbs and eight trigger fingers) noted in 40 children diagnosed at our center between 1995 and 1998 were reviewed with special reference to the spontaneous recovery rate, treatment outcome, and age at presentation. Of the 35 thumb cases, 23 underwent surgical release and all responded satisfactorily to surgical treatment. Spontaneous recovery was noted in 12 trigger thumb cases and in all eight trigger finger cases. Trigger finger developed earlier in life than trigger thumb and the spontaneous recovery rate was higher in trigger finger than trigger thumb.

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Balakrishnan, G., S. Vijayaragavan, and B. Somesh. "Restoration of Five Digit Hand in Type III B & C Thumb Hypoplasia–A Game Changer in Surgical Management." Indian Journal of Plastic Surgery 53, no. 03 (November 25, 2020): 349–56. http://dx.doi.org/10.1055/s-0040-1718858.

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Abstract Background Hypoplasia of thumb is the second common congenital difference of the thumb, next only to duplication. It may occur as an isolated hand difference or as a part of radial longitudinal deficiency. In approximately 60% of these children, the radius shows hypoplasia. The incidence of thumb hypoplasia is one in 100,000 live births. In 50% of these children, the other hand will also have similar deficiency, although variable in severity. Hypoplasia of thumb has been classified into five major categories, according to the increasing severity of hypoplasia. Type III hypoplasia of thumb is characterized by skeletal hypoplasia involving the first metacarpal and carpometacarpal joint, absent intrinsic muscles and rudimentary extrinsic muscles. It was further subclassified into types A, B & C. Type III B, described by Manske and McCarroll, involves extensive deficiency of extrinsic and intrinsic musculature with aplasia of the metacarpal base. Type III C, described by Buck-Gramcko, has hypoplastic metacarpal head. Methods It is widely believed that reconstruction of Type III B & C hypoplastic thumb will not be functionally useful, and they are often included in the indications for pollicization in thumb hypoplasia. In India, we frequently come across parents, who are not willing to remove the hypoplastic digit. This forced us to find out a way to reconstruct the hypoplastic thumb into a functionally useful digit. We describe our surgical technique of reconstruction of hypoplastic thumbs and our experience in utilization of the technique in five children with Type III B & C hypoplasia of thumb. Carpometacarpal joint of thumb was reconstructed and stabilized with a toe phalangeal transfer in the first stage and an opponensplasty was done in the second stage to improve movement. Results In all the five operated children, our surgical technique yielded a stable thumb which was functional. The donor site morbidity was acceptable. The parents were satisfied with the appearance and functional improvement. Conclusion Surgical reconstruction of hypoplastic thumbs of Type III B & C is possible, and conversion of these poorly developed remnants into a useful digit by our surgical technique is a gamechanger in the management of thumb hypoplasia.

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Onta, Pratyenta Raj, Pabin Thapa, Upendra Jung Thapa, Krishna Sapkota, and Niraj Ranjeet. "Result of Percutaneous Release of Trigger Thumb: A Prospective Study." Nepal Journal of Medical Sciences 6, no. 2 (December 31, 2021): 46–50. http://dx.doi.org/10.3126/njms.v6i2.42531.

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Introduction: Trigger thumb is a common disorder characterized by pain, snapping, and locking of fingers. It usually affects the ring and thumb finger. The treatment of trigger thumb varies according to the grade of triggering. Open surgical release of A1 pulley in trigger thumb is a widely accepted treatment method having its complications like scar mark, pain at the incision site, joint stiffness, and digital nerve injuries. The percutaneous release does have good results in recent studies. It is an easy daycare procedure with low complications. Methods: This study includes 28 patients with trigger thumbs who underwent percutaneous release. Patients were followed up for 6 months duration. Results: There were 30 patients included in the study, only 2 patients required open release so we had an overall 93.33% success rate of percutaneous release. There was no clinical evidence of complications and nerve injury. Conclusion: The percutaneous release is a safe and effective outpatient procedure in patients with trigger thumbs.

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Palca, Joseph. "Four Thumbs Up—One Thumb Down." Science 253, no. 5020 (August 9, 1991): 624. http://dx.doi.org/10.1126/science.253.5020.624.b.

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PALCA, J. "Four Thumbs Up--One Thumb Down." Science 253, no. 5020 (August 9, 1991): 624. http://dx.doi.org/10.1126/science.253.5020.624-a.

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BORETTO, J., V. ALFIE, A. DONNDORFF, G. GALLUCCI, and P. DE CARLI. "A Prospective Clinical Study of the A1 Pulley in Trigger Thumbs." Journal of Hand Surgery (European Volume) 33, no. 3 (June 2008): 260–65. http://dx.doi.org/10.1177/1753193408087070.

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A prospective study was performed in 19 patients with trigger thumbs to define the anatomy of the A1 pulley of the thumb in this condition and to evaluate biomechanical parameters of the thumb after complete division of the A1 pulley. Pre- and postoperatively, flexion of the interphalangeal and metacarpophalangeal joints, key pinch strength and tip pinch strength were measured and compared with these measurements on the contralateral thumb. We identified three types of A1 pulley. The clinical data showed that there is no deficit with respect to motion and strength of the thumb after completely sectioning any of the three types of A1 pulley.

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CHIKURA, BATSI, TONIA MOORE, JOANNE MANNING, ANDY VAIL, and ARIANE L. HERRICK. "Thumb Involvement in Raynaud’s Phenomenon as an Indicator of Underlying Connective Tissue Disease." Journal of Rheumatology 37, no. 4 (March 1, 2010): 783–86. http://dx.doi.org/10.3899/jrheum.091117.

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Objective.To conduct a retrospective study to assess whether the degree of thumb involvement differs between primary Raynaud’s phenomenon (PRP) and secondary Raynaud’s phenomenon (SRP).Methods.Thermography images from all patients attending Salford Royal Hospital and referred for thermography for assessment of RP between 2004 and 2006 were retrospectively reviewed. A distal dorsal difference (DDD) of −1°C or less between the fingertips and dorsum of the hand (fingers cooler) at 23°C was considered clinically relevant. The worse score (the lower score, i.e., the more negative value) from each pair of digits was considered for analysis.Results.One hundred seventy patients fulfilled the study criteria. DDD at 23°C for the thumbs were significantly higher (digital tips warmer) compared with other digits (p < 0.001) in both PRP and SRP. All digits were significantly warmer in PRP compared to SRP with the exception of the thumbs. The proportion of patients with clinically relevant involvement of thumbs was significantly higher in SRP compared to PRP (p = 0.003) and this difference was more pronounced in the thumbs compared with other digits.Conclusion.Although the median temperature gradient along the thumb was not significantly different between SRP and PRP, the thumb is more likely to be involved in SRP than in PRP. Thumb involvement is one of a number of clinical indicators that should alert the clinician to the possibility of an underlying connective tissue disease/disorder.

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WOO, S. H., J. S. KIM, H. H. KIM, and J. H. SEUL. "Microsurgical Reconstruction of Partial Thumb Defects." Journal of Hand Surgery 24, no. 2 (April 1999): 161–69. http://dx.doi.org/10.1054/jhsb.1998.0176.

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We have reconstructed thumb defects using microsurgical techniques in 43 patients. The flap survival was 100% and functional improvement with near normal appearance was obtained in the reconstructed thumbs. In order to obtain satisfactory results, donor sites were confined to the great toe and its adjacent structures and adventitia was removed from the vascular pedicle, which was transferred by subcutaneous tunnelling to minimize scar formation in the reconstructed thumb. The width of transferred nail and pulp volume were matched to the defect in the thumb before transfer.

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Minami, Akio, Norimasa Iwasaki, Keiji Kutsumi, Naoki Suenaga, and Kazunori Yasuda. "A LONG-TERM FOLLOW-UP OF SILICONE-RUBBER INTERPOSITION ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 10, no. 01 (July 2005): 77–82. http://dx.doi.org/10.1142/s0218810405002607.

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There are several surgical options for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. This paper presents our long-term clinical and radiographic review of 12 thumbs in ten patients treated by partial trapezial excision and silicone-rubber interposition arthroplasty. The follow-up period averaged 15; three years with a ten-year minimum. Although the procedure provided early pain relief in most thumbs, all but two had mild to severe pain at follow-up. The average range of post-operative palmar abduction was 23°. The average post-operative grip strength was 9.5 kg. Both tip and key pinch between thumb and index finger averaged about 50% that of normal subjects. Dislocation of the implant occurred in two joints and breakages in five. Bony erosions around the implant, which we attributed silicone synovitis, were found in four thumbs. The indications for silicone-rubber interposition arthroplasty for OA of the thumb CMC joint should be severely restricted as these produced unsatisfactory long-term results.

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MATHOULIN, C., P. MOREEL, R. COSTA, and S. M. WILSON. "Abductor Pollicis Longus “Hammock” Ligamentoplasty for Treatment of First Carpometacarpal Arthritis." Journal of Hand Surgery (European Volume) 33, no. 3 (June 2008): 292–97. http://dx.doi.org/10.1177/1753193408087073.

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The association of trapeziectomy with ligamentoplasty is a simple treatment for osteoarthritis at the base of the thumb. Here we present the long-term results of a technique that creates a “hammock” under the first metacarpal bone using the Abductor Pollicis Longus tendon. This paper reports the results of treatment by this operation of 60 thumbs in 50 patients, including 13 men and 37 women of average age 60 (46–75) years. Thirty thumbs presented with severe pain and 30 with moderate pain. At final follow-up, 47 thumbs (78%) had experienced dramatic relief of pain following the procedure, 12 (20%) thumbs still had mild pain and one (2%) thumb had severe pain. No patients needed revision.

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SHIBU, M. M., and D. GAULT. "Post-Traumatic Digital Overgrowth." Journal of Hand Surgery 21, no. 2 (April 1996): 283–95. http://dx.doi.org/10.1016/s0266-7681(96)80118-5.

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A case is reported of length discrepancy between the two thumbs in a 12-year-old girl following trauma to her left thumb twice before the age of 3 years. The distal phalanx of the left thumb overgrew by 5 mm. There was no functional disability and surgery was requested to improve the appearance.

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EL-KAREF, ESSAM. "The Non-Opposable Triphalangeal Thumb: A New Technique of Management." Journal of Hand Surgery 29, no. 6 (December 2004): 544–51. http://dx.doi.org/10.1016/j.jhsb.2004.07.005.

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Fifteen non-opposable triphalangeal thumbs (eight patients) were treated with a new two-staged surgical technique. The first stage included excision of the proximal interphalangeal joint and osteotomy of the thumb metacarpal, and aimed to restore a correct thumb length, position and alignment and to create a wide thumb web space. The second stage consisted of an opponensplasty with refining of any of the first stage components, as necessary. The mean age at surgery was 3.2 years (range, 2.5–6 years). After a mean follow-up period of 42 months (range, 26 months to 7 years), the targets of treatment had been accomplished without loss of growth potential, joint stability or thumb motion. All children had improved function and cosmesis of the hand.

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Jung, H. J., J. S. Lee, K. S. Song, and J. J. Yang. "Conservative treatment of pediatric trigger thumb: follow-up for over 4 years." Journal of Hand Surgery (European Volume) 37, no. 3 (October 14, 2011): 220–24. http://dx.doi.org/10.1177/1753193411422333.

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We analyzed the outcomes of our conservative treatment for pediatric trigger thumb. Since March 2004, we have used conservative treatment for all patients with pediatric trigger thumb. We prospectively analyzed 30 patients in whom 35 thumbs were affected (10 right, 15 left, 5 bilateral). The mean age at diagnosis was 28 (11–50) months. The treatment consisted of passive exercises performed by the children’s mothers, 10–20 times daily. How reliably this was performed is unproven. Trigger thumb severity was graded as 0A (extension beyond 0°), 0B (extension to 0°), 1 (active extension with triggering), 2 (passive extension with triggering), and 3 (cannot extend either actively or passively i.e. locked). At diagnosis, six of the 35 thumbs (17%) were grade 1, 25 (71%) were grade 2, and four (11%) were grade 3. After a mean follow-up period of 63 (range, 49–73) months, 28 thumbs (80%) were grade 0A or 0B, 5 (14%) were grade 1 and 2 (6%) were grade 2. The bilateral cases and the patients who initially had grade 3 severity had significantly more unfavorable results than the other patients. This study suggests that conservative treatment for pediatric trigger thumb is a successful method, although cases that present with bilateral involvement or locking (grade 3) should be considered for early surgical release.

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Shin, Yong-Eun, Sung-Joon Kim, Jeong-Sang Kim, Kwon-Young Kwak, Ji-Hyo Kim, and Jong-Pil Kim. "Efficiency of magnetic resonance imaging for diagnosing unstable ligament injuries around the thumb metacarpophalangeal joint: A comparison to arthroscopy." Journal of Orthopaedic Surgery 28, no. 3 (May 1, 2020): 230949902097830. http://dx.doi.org/10.1177/2309499020978308.

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Purpose: This study aimed to assess the accuracy of MRI in identifying ulnar collateral ligament (UCL), radial collateral ligament (RCL), and volar plate (VP) injuries of the metacarpophalangeal joint (MCPJ) of the thumb by comparing with diagnostic arthroscopy. Methods: A total of 56 consecutive patients (56 thumbs) who underwent arthroscopy of MCPJ of thumb were enrolled. MRI findings reviewed by consensus reading of two blinded radiologists were compared with arthroscopic examination. Statistical data, including sensitivity, specificity, accuracy, were analyzed. Additionally, the performance characteristics between 3.0-tesla (39 thumbs) and 1.5-tesla (17 thumbs) MRI and acute (≤4 weeks after injury) and chronic (>4 weeks) injuries were compared. Results: Of the 56 thumbs, 38 thumbs (67.9%) showed complete correspondence between MRI and arthroscopic findings. The sensitivity, specificity and accuracy of MRI for detecting UCL injuries were 78.8%, 87.0%, and 82.1%, respectively. The sensitivity, specificity and accuracy of MRI for detecting RCL injuries were 85.7%, 91.4%, and 85.7%, respectively. The sensitivity, specificity, and accuracy of MRI for detecting VP injuries were 89.5%, 89.2%, and 81.0%, respectively. 3.0-tesla MRI showed higher correspondence with arthroscopic observation (76.9%) than 1.5-tesla MRI (47.1%) (p = 0.028). For acute injuries, 78.4% showed complete correspondence between MRI and arthroscopic findings, whereas 47.4% with chronic injuries revealed complete agreement (p = 0.019). Conclusion: Overall, MRI is moderately effective in evaluating ligamentous lesions around MCPJ of thumb, but MRI is more sensitive in diagnosing acute injuries. Furthermore, 3.0-tesla MRI can provide results with better accuracy for diagnosing ligamentous lesions around MCPJ of thumb. However, the sensitivity and the specificity are not applicable to all ligament injuries, but only the severe one which would agree for surgical options.

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Zhang, G., J. Ju, L. Li, G. Jin, X. Li, and R. Hou. "Combined two foot flaps with iliac bone graft for reconstruction of the thumb." Journal of Hand Surgery (European Volume) 41, no. 7 (January 14, 2016): 745–52. http://dx.doi.org/10.1177/1753193415626586.

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The purpose of this report was to retrospectively review the results of reconstruction of the thumb by use of combined two foot flaps with an iliac bone graft. From 2009 to 2014, nine patients with traumatic amputation of the thumb had their thumbs reconstructed. The two flaps were based on one pedicle. All flaps survived completely. Patients were followed for a mean of 15.6 months (range, 6–35 months). The appearance of the reconstructed thumb was comparable to a normal one, except for one thumb which required debulking. The appearance of the nail was satisfactory without deformity. The range of joint motion was satisfactory. The two point discrimination of the pulp ranged from 6 mm to >15 mm. The Michigan Hand Questionnaire outcome score was a mean of 76.2 ± 11.3 points and the Maryland foot rating score a mean of 94.8 ± 3.4 points. The combined two foot flaps with iliac bone graft might provide an option for the reconstruction of the thumb. Level of evidence: III

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Tonkin, Ma, and Km Rumball. "The Bilhaut-Cloquet Procedure Revisited." Hand Surgery 02, no. 01 (July 1997): 67–74. http://dx.doi.org/10.1142/s0218810497000124.

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We have found the Bilhaut-Cloquet procedure, with certain modifications, to be a useful method of reconstruction of thumb duplication. Seven thumbs were reviewed at an average follow-up of two years. A thumb of normal size and stability was obtained. Interphalangeal joint motion was 50% of normal. Nail ridging was considered to be less than satisfactory in one case only.

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Moriya, K., T. Uchiyama, and Y. Kawaji. "COMPARISON OF THE SURGICAL OUTCOMES FOR TRIGGER FINGER AND TRIGGER THUMB: PRELIMINARY RESULTS." Hand Surgery 10, no. 01 (July 2005): 83–86. http://dx.doi.org/10.1142/s0218810405002619.

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We reviewed 110 trigger digits, treated surgically, to compare the outcomes of trigger finger and trigger thumb in terms of peri-operative characteristics and complications. The patients with trigger thumb complained mainly of pain on motion, while those with trigger finger complained of triggering or limited range of motion. Trigger fingers had a significantly longer duration before surgery than did trigger thumbs. Trigger fingers took significantly longer for the symptoms to subside. In our series, 64% of trigger fingers had a flexion contracture of the PIP joint more than three weeks after surgery. Our results suggest that the peri-operative characteristics and outcomes differ between trigger finger and thumb, and that the surgical outcome for trigger finger was poorer than that for trigger thumb, partly due to flexion contracture of the PIP joint.

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Yap, P., A. Z. M. Saad, W. A. Wan Sulaiman, S. F. N. M. Johar, and N. S. M. Shah. "First dorsal metacarpal artery flap in soft tissue reconstruction of recurrent thumb squamous cell carcinoma." Siberian journal of oncology 22, no. 3 (June 28, 2023): 162–67. http://dx.doi.org/10.21294/1814-4861-2023-22-3-162-167.

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Background. Subungual squamous cell carcinoma (SCC) of thumb is a rare disease. However, it is the most common malignancy affecting the nail bed. Early recognition is crucial and important for prompt diagnosis and effective treatment. Often this tumour needs to be treated surgically with wide local resection, which results in a defect in the thumb. If not handled appropriately, such defects render restriction in functionality of the involved thumb as well as a poor aesthetic outcome. In the worst-case scenario, it may result in a poor function of involved hand. Thus, reconstruction of the involved thumb is necessary. The main aim of reconstruction is to regain the hands' function and preserved the thumbs' sensation. Secondarily, to have an aesthetically pleasing hand. Our hands carry out delegate job and important duty for daily function. Especially, the thumb working together with the other fingers to carry out the hand function as one unit. Loss of thumb function affects the whole performance of the hand. Case descriptions. We report a case of recurrent subungual squamous cell carcinoma of thumb, which had wide local resection and subsequently underwent soft tissue coverage with an islanded first dorsal metacarpal artery (FDMA) perforator flap. One month after surgery, the patient was able to regain a good functional outcome of the hand. In this report, we discussed the procedures that had been done. Conclusion. The patient regained full functional hand after reconstruction with preserved sensation over distal thumb. The aesthetic outcome is satisfactory. The FDMA perforator flap is a very pliable and robust flap for reconstruction of distal thumb defect.

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Weiss, Peter. "Physics Rule of Thumb Gets Thumbs Down." Science News 156, no. 22 (November 27, 1999): 342. http://dx.doi.org/10.2307/4011945.

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Boone, Kyle Brauer. "Thumbs Down on These Rules of Thumb." Journal of the International Neuropsychological Society 8, no. 3 (March 2002): 477–79. http://dx.doi.org/10.1017/s135561770224326x.

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Huffman, Rebel, and Ghazi M. Rayan. "THUMB METACARPOPHALANGEAL ARTHRODESIS WITH LOCAL BONE GRAFTING." Hand Surgery 16, no. 01 (January 2011): 55–61. http://dx.doi.org/10.1142/s0218810411005072.

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A restrospective study identified 47 thumb MP joints in 41 patients who underwent arthrodeses using cup and cone osteotomy secured with Kirschner-wire fixation and augmented with local bone graft from the thumb metacarpal. Union rate was 96% averaging 6.8 weeks. Two patients had nonunion; 6.3 year follow-up of 15 thumbs showed improvement of or no pain. MHQ scores were 56.5 in the operative hand and 66.7 in the contralateral hand. Thumb MP arthrodesis augmented with local bone graft negates the morbidity of obtaining distant graft. It is a safe and effective technique that provides excellent pain relief with an acceptable union rate.

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Palomo-López, Patricia, Ricardo Becerro-de-Bengoa-Vallejo, Daniel López-López, César Calvo-Lobo, Manuel Herrera-Lara, Jorge Murillo-González, and Marta Losa-Iglesias. "Anatomic Association of the Proximal Fingernail Matrix to the Extensor Pollicis Longus Tendon: A Morphological and Histological Study." Journal of Clinical Medicine 7, no. 12 (November 22, 2018): 465. http://dx.doi.org/10.3390/jcm7120465.

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Background: Extensor tendon disorders may cause severe functional impairments, and there is a lack of knowledge about their anatomic associations with the proximal fingernail matrix. Objective: To delineate the association between the distal extensor pollicis longus tendon (EPLT) insertion and the limit of the fingernail matrix in the thumb. Methods: The limit of the fingernail matrix and the distal bony insertion of the EPLT were identified in five thumbs from fresh-frozen human cadavers. An additional five thumbs were fixed and the longitudinal thumb sections were histologically analyzed. Results: The terminal limit of the matrix and fingernail was dorsal and overlapped to the EPL tendon, which was located between the fingernail matrix and the phalanx, and extended dorsally to the distal section of the terminal phalanx in all ten thumb bodies. Conclusion: The fingernail matrix is not directly inserted into the periosteum of the dorsal section of the base to the distal phalanx, because this anatomic relationship is separated by the deep fibers of the EPLT.

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Liu, Bo, Shanlin Chen, Esther Ching San Chow, Pengcheng Li, Kun Liu, and Chen Yang. "Type IIIB and IV hypoplastic thumb reconstruction with non-vascularized fourth metatarsal." Journal of Hand Surgery (European Volume) 45, no. 7 (July 1, 2020): 722–28. http://dx.doi.org/10.1177/1753193420937547.

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We treated 16 patients with 17 hypoplastic thumbs (eight Type IIIB and nine Type IV) using a non-vascularized fourth metatarsal transfer with a rotational flap and multi-staged reconstruction. The average age at the first operation was 24 months. The average follow-up time was 46 months. All patients achieved reasonable hand function and were able to use the reconstructed thumb to grip small and large objects. The operated thumb achieved an average Kapandji score of 6.7 and average pinch strength of 0.9 kg. There were two cases of graft nonunion. All parents are satisfied with the function and appearance of the reconstructed thumb and donor foot. We conclude that non-vascularized fourth metatarsal transfer is a feasible reconstruction method for patients with Types IIIB and IV hypoplastic thumbs. The reconstruction allows for the preservation of a 5-digit hand with reasonable function and appearance and minimal donor site morbidity, although long-term growth of the metatarsals still need to be monitored. Level of evidence: IV

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Pan, Z. J., J. Qin, X. Zhou, and J. Chen. "Robust thumb flexor tendon repairs with a six-strand M-Tang method, pulley venting, and early active motion." Journal of Hand Surgery (European Volume) 42, no. 9 (August 8, 2017): 909–14. http://dx.doi.org/10.1177/1753193417723238.

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We present the outcomes of flexor pollicis longus tendon repairs in 34 thumbs using a six-strand M-Tang repair with venting of one or two pulleys according to site of tendon laceration. The A2 pulley was vented in all three thumbs with zone 1 injury. In 31 thumbs with zone 2 injuries, the oblique pulley was vented partially or entirely. Twenty-two thumbs had both the A1 and oblique pulleys vented. Six to 46 months post-surgery, 14 thumbs with zone 2 injuries were rated excellent, 13 good, three fair and one failure according to Tang criteria. No tendon ruptures or bowstringing occurred. Fourteen of 34 thumbs had deficits in interphalangeal joint extension averaging 13°. We conclude that venting of one or two pulleys may ensure recovery of thumb function without risking tendon bowstringing and that early active thumb motion is safe with a robust tendon repair. Level of evidence: IV

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Wood, V. E., and J. H. Rubinstein. "Surgical Treatment of the Thumb in the Rubinstein-Taybi Syndrome." Journal of Hand Surgery 12, no. 2 (April 1987): 166–72. http://dx.doi.org/10.1016/0266-7681_87_90005-2.

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In a review of 530 individuals with Ruhinstein-Taybi syndrome, 182 (34%) were found to have thumbs in severe radial angulation (“hitch-hiker thumbs”), which prevented opposition and functional gripping strength. Surgery has been performed on 35 thumbs (from 20 patients), usually to correct a delta phalanx deformity. The preferred approach was a closing wedge osteotomy, with a Z-plasty on the concave side to straighten the thumb. In eight and possibly 11 of the 35 thumbs, the angulation deformity or stiffness recurred, emphasizing the importance of proper and careful surgery. We conclude that surgical correction of the deformity is best done before the age of two, so that the thumb is functional during the initial development of hand-eye coordination. Deviation persisting at the age of ten can be corrected by fusing the metacarpophalangeal joint.

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XU, LIN, JIA TAN, PINGOU WEI, XIANG LUO, HAITAO TAN, and CHAITANYA SHAMSUNDER MUDGAL. "CLINICAL APPLICATION OF 3D PRINTING TECHNOLOGY FOR PREOPERATIVE PLANNING OF THUMB RECONSTRUCTION." Acta Ortopédica Brasileira 29, no. 4 (August 2021): 211–18. http://dx.doi.org/10.1590/1413-785220212904235492.

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ABSTRACT Objective: This study aimed to explore the clinical application of preoperative precise design for 3D printing and thumb reconstruction, which could help manage the patients with thumb defect and achieve better function and appearance. Methods: This was a retrospective study of 20 patients who underwent the surgery of harvesting toe transplant and thumb reconstruction between January 2015 and December 2016. The 3D model of the thumb defect was created and printed. The dimensions of skin and bones from donor site were precisely designed as reference for surgical operation. The surgery was performed according to the model. Results: Perfect repair of defects was achieved with satisfying appearance and function. The reconstructed thumbs all survived (survival rate of 100%). Follow-up was 3-9 months. The maximum dorsiflexion was 8-30° and the maximum flexion was 38-58°. The two-point sensory discrimination was 9-11 mm. In total, 17 patients reposted “Excellent” satisfaction and three “Good”, each for the reconstructed thumb and hand function, respectively. The satisfaction rate was 85%. Conclusion: Preoperative digital design and 3D printing according to the donor and recipient sites allowed a tailored operation. The operation was more precise, the appearance of the reconstructed thumb was good. Level of Evidence II, Retrospective Study.

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GÜNAY, Ali E., Kadir TATLISU, Mehmet ÇAVUŞ, and Murat KAHRAMAN. "Mid-Term Results of the First Dorsal Metacarpal Artery Flap for Thumb Defects." Journal of Hand Surgery (Asian-Pacific Volume) 27, no. 05 (October 2022): 834–38. http://dx.doi.org/10.1142/s2424835522500801.

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Background: The thumb plays an important role in the function of the hand. Sensate reconstruction of the pulp is important in restoring function to the thumb. The aim of this study is to present outcomes of a sensate islanded first dorsal metacarpal artery (FDMA) flap used for the reconstruction of skin defects of the thumb. Methods: Patients who had a FDMA flap reconstruction of thumb pulp defects in the orthopaedics and traumatology clinic of affiliated hospital were included in the study. This included eight thumbs of eight patients. The range of motion, sensation and cosmetic satisfaction in the donor and recipient areas were evaluated at a minimum of 2-year follow-up. Results: There were no partial or complete flap failures. The mean static 2-point discrimination was 15 mm and the mean Semmes–Weinstein monofilament test score was 3.93. Cortical re-orientation was observed in 65% of patients. Near normal range of motion and Kapandji scores were regained in all patients. Conclusions: Excellent motion and sensory outcomes were obtained following the FDMA flap reconstruction of thumb pulp defects. The donor morbidity of the flap is minimal, and this flap can be considered as one of the primary options for reconstruction of thumb pulp defects. Level of Evidence: Level V (Therapeutic)

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Kamoi, Fumiki, Makoto Kondo, Masanori Hayashi, Shigeharu Uchiyama, and Hiroyuki Kato. "A new technique to determine the tension in extensor pollicis longus reconstruction." Journal of Hand Surgery (European Volume) 44, no. 8 (May 2, 2019): 790–94. http://dx.doi.org/10.1177/1753193419845281.

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We present an original technique for determining the tension of the extensor pollicis longus tendon after reconstruction. We treated 20 patients using this technique for an extensor pollicis longus tendon graft or extensor indicis tendon transfer and reviewed the results. The tension of the reconstructed extensor pollicis longus was adjusted so that the centre of the distal edge of the thumbnail was elevated 2 cm above the operation table. The mean retropositional distance of the treated thumbs was 1.2 cm less than the contralateral thumbs. The mean total active motion of the thumb was 90%. This technique resulted in satisfactory thumb function. Level of evidence: IV

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Jeon, Sungmi, Seung Min Kim, and Sung Tack Kwon. "Sensate Neurovascular Island Flap for Thumb Reconstruction." Journal of Wound Management and Research 17, no. 1 (February 28, 2021): 48–52. http://dx.doi.org/10.22467/jwmr.2020.01326.

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Thumb pulp defects require adequate reconstruction for satisfactory sensate function and aesthetic appearance. We report a reconstructive case using a sensate neurovascular island flap raised from the ulnar side of the middle finger for a tactile thumb pad defect. The flap was elevated as a modified version of the conventional heterodigital neurovascular island flap in order to restore thumb sensation without the “double-sensibility” phenomenon. The ulnar digital nerve of the flap was sectioned at the middle phalanx level of the donor digit and coaptated to the ulnar and radial digital nerves of the thumb through end-to-side and end-to-end neurorrhaphy. The remaining radial digital nerve of the donor finger was preserved, and the proximal end of the sectioned nerve was coaptated end-to-side to the radial digital nerve to prevent neuroma formation. No postoperative complications including venous congestion were observed. This technique is a relatively simple and reliable option for reconstructing thump pulp defects.

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Miller, N. J. K., and T. R. C. Davis. "Palmar plate capsulodesis for thumb metacarpophalangeal joint hyperextension in association with trapeziometacarpal osteoarthritis." Journal of Hand Surgery (European Volume) 39, no. 3 (June 19, 2013): 272–75. http://dx.doi.org/10.1177/1753193413493368.

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Hyperextension of the thumb metacarpophalangeal (MCP) joint is frequently seen with trapeziometacarpal osteoarthritis, but there is no consensus on the indication for, or type of, treatment. We re-examined 12 thumbs at a mean of 9 (range 6–13) years following MCP capsulodesis using a suture anchor performed with trapeziectomy. Mean MCP hyperextension improved from 45° pre-operatively to 19° at 1 year post-operatively. At 9 years follow-up, it had increased to 30° but was still significantly better than pre-operatively ( p = 0.007). Mean MCP flexion was 37° and near normal opposition was retained. The median pain score had improved from 5.5 to 1 ( p = 0.002). Thumb key and tip pinch and hand grip strength showed no significant change from pre-operative values. No thumb MCP had symptomatic radiological degeneration. Our results suggest that MCP capsulodesis preserves a useful range of MCP flexion but stretches out over time. However, this did not result in increased pain or thumb weakness.

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Rachaveti, Dhanush, Niranjan Chakrabhavi, Vaisakh Shankar, and Varadhan SKM. "Thumbs up: movements made by the thumb are smoother and larger than fingers in finger-thumb opposition tasks." PeerJ 6 (October 18, 2018): e5763. http://dx.doi.org/10.7717/peerj.5763.

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Background In humans, the thumb plays a crucial role in producing finger opposition movements. These movements form the basis of several activities of the hand. Hence these movements have been used to study phenomena like prehension, motor control, motor learning, etc. Although such tasks have been studied extensively, the relative contribution of the thumb vis-à-vis the fingers in finger opposition tasks is not well understood. In this study, we investigated the kinematics of thumb and fingers in a simple finger opposition task. Further, we quantified the relative contribution and the movement smoothness aspects and compared these between fingers and thumb. Methods Eight, young healthy participants (four males and four females) were asked to perform a full finger to thumb opposition movement, where they were required to reach for different phalanges of the fingers. Position (X, Y and Z) of individual segments of the four fingers and the thumb were measured with reference to the wrist by a 16-sensor kinematics measurement system. Displacements and velocities were computed. An index, displacement ratio, that quantifies the relative contribution of thumb and fingers was computed from displacement data. Velocity data was used to quantify the smoothness of movement of thumb and fingers. Results The Displacement Ratio showed that contribution of the thumb is higher than contribution of any other target finger or target phalanges, except for the distal phalanx of the index and middle fingers. Smoothness of movement of the thumb was higher than all the finger phalanges in all cases. Conclusion We conclude that in the task considered (thumb opposition movements to different targets within the hand & fingers), the thumb made a greater relative contribution in terms of displacement ratio and also produced smoother movements. However, smoothness of thumb did not vary depending on the target. This suggests that the traditional notion of the thumb being a special digit when compared to other fingers is true at least for the opposition movements considered in this study.

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van Grunsven, W., C. Njiokiktjien, M. Vranken, and M. Vuylsteke-Wauters. "Ontogenetic Trends in Gnostic Hand Function in 3- to 12-Yr.-Old Children." Perceptual and Motor Skills 96, no. 3_suppl (June 2003): 1043–61. http://dx.doi.org/10.2466/pms.2003.96.3c.1043.

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The intimate relation between the sensory and motor functions of the hands during object manipulation and exploratory touch, the well-known improvement in object handling and constructive performance in ontogenesis and the emergent laterality thereof, assume changes in morphognostic capabilities in children. In this study we tried to corroborate the hypothesis of Mesker that mature and lateralized finger-thumb opposition is preceded by a stage of two-sided manual form agnosia in preschool children, followed by acquisition of morphognosis of the fingers and, finally, the thumbs. This study examined the development of gnostic hand function in 290 children from 3 to 11 years of age who drew the outlines of a meaningless wooden object passively felt with each hand without visual control. Analysis showed a clear ontogenetic change across the two age groups of increasing morphognostic function: 48% of the 6-yr.-olds drew correctly what the fingers of both left and right hands had perceived (thumbs, 14%). Of the 11-yr.-olds 91% and 61% performed perfectly with the right and left hands, respectively. The fingers preceded the thumbs in reproduction by most children, and the correct reproduction by the left thumb precedes that of the right thumb. The ontogenesis of bimanual sensorimotor functioning is discussed in the light of cortical and callosal development.

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Nakada, Mika, Kaoru Tada, Tadahiro Nakajima, Masashi Matsuta, and Hiroyuki Tsuchiya. "A Case of a 5-Year-Old Boy with a Blauth Type IIIB Hypoplastic Thumb Reconstructed with a Nonvascularized, Hemilongitudinal Metatarsal Transfer." Case Reports in Orthopedics 2018 (December 6, 2018): 1–4. http://dx.doi.org/10.1155/2018/8205285.

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The treatment methods used for Blauth type IIIB hypoplastic thumbs are controversial. We performed a nonvascularized, hemilongitudinal metatarsal bone transfer on a 5-year-old boy with a type IIIB hypoplastic thumb. Despite the child’s age, the growth of the thumb was confirmed and the thumb had stabilized. Moreover, growth disorder of the donor toe was not observed. This method is relatively easy to perform. And donor toe deformation can be prevented, because of the preservation of more than half of the metatarsal bone. In our case, the patient was 5 years of age; nevertheless, the epiphyseal line was opened and the grafted metatarsal bone grew. This method is useful in terms of its simplicity and prevention of postoperative complications.

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Journal articles on the topic 'Thumb'

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