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Characteristics of patients with congenital clasped thumb: a prospective study of 40 patients with the results of treatment

  • Original Clinical Article
  • Published:
Journal of Children's Orthopaedics

Abstract

Purpose

Congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed in many congenital syndromes. The aim of this study was to diagnose and evaluate cases of clasped thumb as regards the associated congenital anomalies and syndromes, and evaluation of the results of treatment of such cases.

Methods

A prospective study on 40 patients with 73 clasped thumbs was done. All the patients’ data regarding their personal, family, pregnancy and developmental histories were recorded. All the patients were exposed to thorough clinical and radiological examination and genetic assessment. The cases were classified using the Tsuyuguchi et al. (J Hand Surg [Am] 10:613–618, 1985) classification into three types. Conservative treatment was adopted in ten hands, and surgical treatment was performed for 28 hands in 17 patients, with an average follow-up of 26 months.

Results

Positive consanguinity was recorded in 57.5% of cases. Associated anomalies were recorded in 77.5% of cases. Type I was the most common one, followed by type III and then type II. Conservative treatment is effective in type I cases when presented early, and all patients were satisfied with the results of surgical treatment.

Conclusions

We reported associated anomalies which are to our knowledge have not mentioned before in the literature which include; congenital blindness, radial deviation of the index finger and ventricular septal defect. We found that 68% of the patients had associated syndromes, and this has not been mentioned before. In this study, we found that there were no difference between type II and type III clasped thumb as regards the pathological findings, severity, the operative procedures, the treatment protocol and the operative results. Properly planned treatment gives satisfactory results.

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References

  1. Temtamy S, McKusick V (1978) The genetics of hand malformation. Alan R. Liss, New York

    Google Scholar 

  2. Crawford H, Horton C, Adamson J (1966) Congenital aplasia or hypoplasia of thumb and fingers extensor tendons. J Bone Joint Surg Am 48:82–91

    Google Scholar 

  3. Tsuyuguchi Y, Masda K, Kawabata H, Kawai H, Keiro Ono (1985) Congenital clasped thumb: a review of forty-three cases. J Hand Surg [Am] 10:613–618

    Article  Google Scholar 

  4. Broadbent TR, Woolf RM (1964) Flexion-adduction deformity of the thumb—congenital clasped thumb. Plast Reconstr Surg 34:612–616

    Article  Google Scholar 

  5. Shaw DT, Ricky DG, Nahigian JH (1973) Interdigital butterfly flap in the hand (the double-opposing Z-plasty). J Bone Joint Surg Am 55:1677

    Google Scholar 

  6. Buck-Gramcko D (1998) Congenital malformations of the hand and forearm. Churchill Livingstone, London

    Google Scholar 

  7. Abdel Ghani H (2006) Modified dorsal rotational advancement flap for release of thumb web space. J Hand Surg [Br] 31(2):226–229

    Article  Google Scholar 

  8. Lin SC, Hung TH, Hsu HY, Lin CG, Chiu HY (1999) A simple splinting method for correction of supple congenital clasped thumbs in infants. J Hand Surg [Br] 24:612–614

    Article  Google Scholar 

  9. Flatt AE (1994) The care of congenital hand anomalies. 2nd ed. Quality Medical Publishing, St. Louis

    Google Scholar 

  10. Weckesser EC, Reed JR, Heiple KG (1968) Congenital clasped thumb (congenital flexion-adduction deformity of the thumb). J Bone Joint Surg Am 50:1417–1428

    Google Scholar 

  11. Beals RK (1973) Trico-rhino-phalangeal dysplasia. report of kindred. J Bone Joint Surg Am 55:821–826

    Google Scholar 

  12. Cervenka j, Figalová P, Gorlin RJ (1969) Cranio-carpo-tarsal dysplasia, or the whistling face syndrome II. Oral intercommissural distance in children. Am J Dis Child 117:434–435

    Article  Google Scholar 

  13. Christian JC, Andrews PA, Conneally PM, Muller J (1971) The adducted thumbs syndrome. Clin Genet 2:95–103

    Article  Google Scholar 

  14. Freeman EA, Sheldon JH (1938) Cranio-carpo-tarsal dystrophy. An undescribed congenital malformation. Arch Dis Child 13:277–238

    Article  Google Scholar 

  15. Gilly RJ, Cotton S, Farouz A, Nairet A, Maclet M (1971) Hydrocéphalie congénitale et anomalie bilatérale des pouces: Syndrome malformatif lié au chromosome “X”. Pediatrie 26: 365–378

    Google Scholar 

  16. Janecke AR, Unsinn K, Krecxy A (2001) Adducted thumb-club foot syndrome in sibs of a consanguineous Austrian family. J Med Genet 138:265–269

    Article  Google Scholar 

  17. McCarroll HR, Manske PR (1998) The windswept hand. In: Buck-Gramcko D (ed) Congenital malformations of the hand and forearm. Churchill Livingstone, London, pp 313–325

    Google Scholar 

  18. O’Keefe M, Crawford JS, Young JDH, Macrae WG (1986) Ocular abnormalities in the Freeman–Sheldon syndrome. Am J Ophthalmol 102:346–348

    Article  Google Scholar 

  19. Senrui H (1998) Congenital Contractures. In: Buck-Gramcko D (ed) Congenital malformations of the hand and forearm. Churchill Livingstone, London, pp 295–309

    Google Scholar 

  20. Weinstein S, Grolin RJ (1969) Cranio-carpo-tarsal dysplasia or the whistling face syndrome. Am J Dis Child 117:427–433

    Article  Google Scholar 

  21. Wood VE (1994) Another look at the causes of the windblown hand. J Hand Surg [Br] 19:679–682

    Article  Google Scholar 

  22. Dundar M, Demiryikmaz F, Demiryikmaz I (1997) An autosomal recessive adducted thumb-club foot syndrome observed in Turkish cousins. Clin Gene 51:61–64

    Article  Google Scholar 

  23. Hall J (1981) An approach to congenital contractures (arthrogryposis). Pediatr Ann 10:15

    Google Scholar 

  24. Pozanski AK, LaRowe PC (1970) Radiographic manifestations of arthrogryposis syndrome. Radiology 95:353

    Article  Google Scholar 

  25. Sonoda T, Kouno K (2000) Two brothers with distal arthrogryposis, peculiar facial appearance, cleft palate, short stature, hydronephrosis, retentio testis and normal intelligence: a new type of distal arthrogryposis? Am J Med Genet 10:280–285

    Article  Google Scholar 

  26. Fitch N, Levy EP (1975) Adducted thumb syndromes. Clin Genet 8:190–198

    Article  Google Scholar 

  27. Mih AD (1998) Congenital clasped thumb. Hand Clinics 14:77–84

    Google Scholar 

  28. McCarroll HR (1985) Congenital flexion deformities of the thumb. Hand Clin 1:567–575

    Google Scholar 

  29. Lipskeir E, Weizenbluth M (1989) Surgical treatment of clasped thumb. J Hand Surg [Br] 14:72–79

    Article  Google Scholar 

Download references

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Correspondence to Hisham Abdel Ghani.

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Hisham Abdel Ghani, El-Naggar, A., Hegazy, M. et al. Characteristics of patients with congenital clasped thumb: a prospective study of 40 patients with the results of treatment. J Child Orthop 1, 313–322 (2007). https://doi.org/10.1007/s11832-007-0057-x

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  • DOI: https://doi.org/10.1007/s11832-007-0057-x

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