The windblown hand: correction of the complex clasped thumb deformity

Area of Science:

• Hand surgery
• Orthopedic surgery
• Reconstructive surgery

Background:

• Windblown hand is a complex deformity characterized by thumb adduction contracture, metacarpophalangeal joint flexion contracture, and thenar muscle hypoplasia.
• These deficits significantly impair thumb function and require a multi-faceted surgical approach.

Purpose of the Study:

• To outline the surgical strategies for correcting the distinct deficits in windblown hand deformity.
• To emphasize the necessity of addressing all components for optimal functional recovery.

Main Methods:

• Thumb web space contractures are treated with extensive soft-tissue release and dorsal advancement flaps.
• Metacarpophalangeal joint flexion contractures are managed with soft-tissue release and often joint fusion.
• Thenar muscle hypoplasia is addressed through opponensplasty.

Main Results:

• Successful correction requires a combination of soft-tissue release, potential joint fusion, and opponensplasty.
• Addressing all three deficits is crucial for achieving good thumb function.

Conclusions:

• A comprehensive surgical plan is necessary for effective treatment of windblown hand deformity.
• Restoration of thumb function depends on the simultaneous correction of web space contracture, joint subluxation, and thenar muscle deficiency.