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Journal of Hand Surgery (British and European Volume)
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Articles

The Non-Opposable Triphalangeal Thumb: A New Technique of Management

ESSAM EL-KAREF

From the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Alexandria University, Egypt

Correspondence: Dr Essam El-Karef, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Alexandria University, 203 Thiebah Street, 26B Sporting, Alexandria, Egypt. Tel.: +20-354-44-374/+2-012-2702514; fax: +20-354-10240. E-mail: elkaref{at}hotmail.com (E. El-Karef).

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.

Key Words: triphalangeal • pollicization • thumb • osteotomy • five fingered

Journal of Hand Surgery (British and European Volume), Vol. 29, No. 6, 544-551 (2004)
DOI: 10.1016/J.JHSB.2004.07.005
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