The Thumb pp 99-108 | Cite as

Other Developmental Anomalies

  • Hyun Dae Shin
  • Soo Min Cha


In this chapter, relatively rare congenital lesions are discussed. Clasped thumb has various clinical presentations, and especially in arthrogryposis, there are several different patterns of hand deformities according to the arthrogryposis subtypes. Other lesions such as trigger thumb, triphalangeal thumb, and symphalangism should be managed under the thorough understanding for the natural history, complications, and prognosis.


Clasped thumb Arthrogryposis Triphalangeal thumb Symphalangism 


  1. 1.
    Lipskeir E, Weizenbluth M. Surgical treatment of the clasped thumb. J Hand Surg Br. 1989;14(1):72–9.CrossRefGoogle Scholar
  2. 2.
    HR MC Jr, Manske PR. The windblown hand: correction of the complex clasped thumb deformity. Hand Clin. 1992;8(1):147–59.Google Scholar
  3. 3.
    Weckesser EC. Congenital flexion-adduction deformity of the thumb (congenital clasped thumb). J Bone Joint Surg Am. 1955;37(5):977–83; discussion 983–984.CrossRefGoogle Scholar
  4. 4.
    McCarroll HR Jr. Congenital flexion deformities of the thumb. Hand Clin. 1985;1(3):567–75.PubMedGoogle Scholar
  5. 5.
    Broadbent TR, Woolf RM. Flexion-adduction deformity of the thumb: congenital clasped thumb. Plast Reconstr Surg. 1964;34:612–6.CrossRefGoogle Scholar
  6. 6.
    White JW, Jensen WE. The infant’s persistent thumb-clutched hand. J Bone Joint Surg Am. 1952;24(3):680–8.CrossRefGoogle Scholar
  7. 7.
    Mih AD. Congenital clasped thumb. Hand Clin. 1998;14:77–84.PubMedGoogle Scholar
  8. 8.
    Lin SC, Hung TH, Hsu HY, Lin CG, Chiu HY. A simple splinting method for correction of supple congenital clasped thumbs in infants. J Hand Surg Br. 1999;24:612–4.CrossRefGoogle Scholar
  9. 9.
    Tsuyuguchi Y, Masda K, Kawabata H, Kawai H, Ono K. Congenital clasped thumb: a review of forty-three cases. J Hand Surg Am. 1985;10:613–8.CrossRefGoogle Scholar
  10. 10.
    Weckesser EC, Reed JR, Heiple KG. Congenital clasped thumb (congenital flexion-adduction deformity of the thumb). J Bone Joint Surg Am. 1968;50:1417–28.CrossRefGoogle Scholar
  11. 11.
    Buck-Gramcko D. Syndactyly between the thumb and index finger. In: Buck-Gramcko D, editor. Congenital malformation of the hand and forearm. New York: Churchill Livingstone; 1998. p. 141–7.Google Scholar
  12. 12.
    Ghani HA. Modified dorsal rotation advancement flap for release of the thumb web space. J Hand Surg Br. 2006;31:226–9.CrossRefGoogle Scholar
  13. 13.
    Ezaki MB, Oishi SN. Index rotation flap for palmar thumb release in arthrogryposis. Tech Hand Up Extrem Surg. 2010;14(1):38–40.CrossRefGoogle Scholar
  14. 14.
    Mahmoud M, Abdel-Ghani H, Elfar JC. New flap for widening of the web space and correction of palmar contracture in complex clasped thumb. J Hand Surg Am. 2013;38(11):2251–6. Scholar
  15. 15.
    Abdel-Ghani H, Mahmoud M, Shaheen A, Abdel-Wahed M. Treatment of congenital clasped thumb in arthrogryposis. J Hand Surg Eur Vol. 2017;42(8):794–8. Epub 2017 Jun.CrossRefPubMedGoogle Scholar
  16. 16.
    Rodgers WB, Waters PM. Incidence of trigger digits in newborns. J Hand Surg Am. 1994;19(3):364–8.CrossRefGoogle Scholar
  17. 17.
    Slakey JB, Hennrikus WL. Acquired thumb flexion contracture in children: congenital trigger thumb. J Bone Joint Surg Br. 1996;78(3):481–3.CrossRefGoogle Scholar
  18. 18.
    Moon WN, Suh SW, Kim IC. Trigger digits in children. J Hand Surg Br. 2001;26(1):11e12.CrossRefGoogle Scholar
  19. 19.
    Kikuchi N, Ogino T. Incidence and development of trigger thumb in children. J Hand Surg Am. 2006;31(4):541–3.CrossRefGoogle Scholar
  20. 20.
    Verma M, Craig CL, DiPietro MA, Crawford J, VanderHave KL, Farley FA, Caird MS. Serial ultrasound evaluation of pediatric trigger thumb. J Pediatr Orthop. 2013;33:309–13.CrossRefGoogle Scholar
  21. 21.
    Kim J, Gong HS, Seok HS, Choi YH, Oh S, Baek GH. Quantitative measurements of the cross-sectional configuration of the flexor pollicis longus tendon using ultrasonography in patients with pediatric trigger thumb. J Hand Surg Am. 2018;43(3):e1–284.e7. pii: S0363-5023(16)31116-9. [Epub ahead of print].CrossRefGoogle Scholar
  22. 22.
    Dinham JM, Meggitt BF. Trigger thumbs in children. A review of the natural history and indications for treatment in 105 patients. J Bone Joint Surg Br. 1974;56(1):153–5.PubMedGoogle Scholar
  23. 23.
    Michifuri Y, Murakami T, Kumagai S, et al. Natural history of the trigger finger in children. Seikei Geka. 1978;29:1648.Google Scholar
  24. 24.
    Sugimoto Y. Treatment of trigger finger digit in children. Seikei Geka. 1991;23:1047.Google Scholar
  25. 25.
    Baek GH, Lee HJ. The natural history of pediatric trigger thumb: a study with a minimum of five years follow-up. Clin Orthop Surg. 2011;3(2):157–9. Epub 2011 May 12.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Baek GH, Kim JH, Chung MS, Kang SB, Lee YH, Gong HS. The natural history of pediatric trigger thumb. J Bone Joint Surg Am. 2008;90(5):980–5. Scholar
  27. 27.
    Shah AS, Bae DS. Management of pediatric trigger thumb and trigger finger. J Am Acad Orthop Surg. 2012;20:206–13.CrossRefGoogle Scholar
  28. 28.
    Nemoto K, Nemoto T, Terada N, Amako M, Kawaguchi M. Splint therapy for trigger thumb and finger in children. J Hand Surg Br. 1996;21(3):416–8.CrossRefGoogle Scholar
  29. 29.
    Kozin SH. Deformities of the thumb. In: Wolfe SW, Pederson WC, editors. Green’s operative hand surgery. 6th ed. Philadelphia: Elsevier; 2011. p. 1371–403.CrossRefGoogle Scholar
  30. 30.
    Wang HC, Lin GT. Retrospective study of open versus percutaneous surgery for trigger thumb in children. Plast Recontr Surg. 2005;115:1963–70.CrossRefGoogle Scholar
  31. 31.
    Wood VE. Treatment of the triphalangeal thumb. Clin Orthop. 1976;1120:188–200.Google Scholar
  32. 32.
    Horii E, Nakamura R, Makino H. Triphalangeal thumb with associated abnormalities: clinical characteristics and surgical outcomes. Plast Reconstr Surg. 2001;108:902–7.CrossRefGoogle Scholar
  33. 33.
    Wang AA, Hutchinson DT. Results of treatment of delta triphalangeal thumbs by excision of the extra phalanx. J Pediatr Orthop. 2015;35(5):474–7. Scholar
  34. 34.
    Jennings JF, Peimer CA, Sherwin FS. Reduction osteotomy for triphalangeal thumb: an 11-year review. J Hand Surg. 1992;17A:8–14.CrossRefGoogle Scholar
  35. 35.
    Gousheh J, Arasteh E. Isolated bilateral triphalangeal thumb with delta phalanx: a case report. World J Plast Surg. 2013;2(2):111–4.PubMedPubMedCentralGoogle Scholar
  36. 36.
    Flatt AE. The care of congenital hand anomalies. St. Louis: Mosby; 1977. p. 146–70.Google Scholar
  37. 37.
    Ogino T, Minami A, Fukuda K, Kato H. Congenital anomalies of the upper limb among the Japanese in Sapporo. J Hand Surg Br. 1986;11(3):364–71.CrossRefGoogle Scholar
  38. 38.
    Cushing H. Hereditary anchylosis of the proximal phalangeal joints (symphalangism). Proc Natl Acad Sci U S A. 1915;1(12):621–2. No abstract availableCrossRefGoogle Scholar
  39. 39.
    Drinkwater H. Phalangeal anarthrosis (Synostosis, Ankylosis) transmitted through Fourteen Generations. Proc R Soc Med. 1917;10(Pathol Sect):60–8. No abstract available.Google Scholar
  40. 40.
    Takahashi T, Takahashi I, Komatsu M, Sawaishi Y, Higashi K, Nishimura G, Saito H, Takada G. Mutations of the NOG gene in individuals with proximal symphalangism and multiple synostosis syndrome. Clin Genet. 2001;60(6):447–51.CrossRefGoogle Scholar
  41. 41.
    Takano K, Ogasawara N, Matsunaga T, Mutai H, Sakurai A, Ishikawa A, Himi T. A novel nonsense mutation in the NOG gene causes familial NOG-related symphalangism spectrum disorder. Hum Genome Var. 2016;3:16023. eCollection 2016.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Baek GH, Lee HJ. Classification and surgical treatment of symphalangism in interphalangeal joints of the hand. Clin Orthop Surg. 2012;4(1):58–65. Epub 2012 Feb 20.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Takagi R, Kawabata H, Matsui Y. Thumb polydactyly with symphalangism in young children. J Hand Surg Eur Vol. 2009;34(6):800–4. Epub 2009 Jul 10.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hyun Dae Shin
    • 1
  • Soo Min Cha
    • 1
  1. 1.Department of Orthopaedic SurgeryChungnam National UniversityDaejeonSouth Korea

Personalised recommendations