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Review
. 2016 Aug;32(3):417-21.
doi: 10.1016/j.hcl.2016.03.012. Epub 2016 May 21.

Tendon Transfers for the Hypoplastic Thumb

Lindley B Wall  1 , Charles A Goldfarb  2
Affiliations
Review

Tendon Transfers for the Hypoplastic Thumb

Lindley B Wall et al. Hand Clin. 2016 Aug.

Abstract

Thumb hypoplasia is a component of radial longitudinal deficiency. The severity of hypoplasia can range from a slightly smaller thumb to a complete absence. Types II and IIIA hypoplastic thumbs are candidates for reconstruction to improve function, stability, and strength. There are 2 commonly used tendon transfers that can augment thumb opposition strength: the Huber abductor digiti minimi muscle transfer and the flexor digitorum superficialis opposition transfer. Both transfers use ulnar-sided structures to augment the thenar musculature. The Huber opposition transfer increases thenar bulk, but does not provide additional tissue for metacarpophalangeal stability.

Keywords: Flexor digitorum superficialis; Huber; Hypoplastic thumb; Opposition transfer; Radial longtitudinal deficiency.

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Figures

Figure 1
Figure 1
The incisions for the Huber opposition transfer. A curvilinear incision is made along the ulnar boarder of the hand and a second incision is placed over the radial boarder of the thumb MP joint.
Figure 2
Figure 2
The ADM muscle is transferred across the palm to the thumb MP joint, passed subcutaneously.
Figure 3
Figure 3
The incisions for the FDS opposition transfer. One incision is made at the base of the ring finger for harvest of the FDS tendon. A second incision is made proximal to the wrist flexion crease to bring out the FDS tendon and placed through the FCU tendon. A third incision is made over the radial boarder of the thumb MP joint.
Figure 4
Figure 4
The FDS tendon is transferred across the palm to the thumb MP joint, passed subcutaneously.
See this image and copyright information in PMC

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