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Correction of the typical cleft hand.

Joseph Upton¹, Amir H Taghinia

¹Department of Plastic and Oral Surgery, Children's Hospital, Boston, MA 02115, USA. jupton3@gmail.com

The Journal of Hand Surgery

|February 9, 2010

Summary

This study presents a surgical technique for correcting complex cleft hands, focusing on the challenging index ray. The method aims to improve hand function and avoid long-term complications.

Area of Science:

Orthopedics
Hand Surgery
Congenital Hand Deformities

Background:

Cleft hand malformations, particularly Type II and III, present complex challenges.
Associated anomalies include syndactyly, hypoplasia, and abnormal digital structures.
The index ray is particularly difficult to reconstruct due to its central location.

Purpose of the Study:

To describe a novel surgical technique for the correction and transposition of the index ray in Type II and III cleft hands.
To address the challenges posed by the index ray's position between the thumb and central cleft.
To improve functional outcomes and prevent long-term complications.

Main Methods:

A surgical technique involving a single incision to separate glabrous and dorsal skin surfaces.

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Precise skeletal alignment of the index ray.

Emphasis on preserving the adductor pollicis muscle for functional pinch.

Main Results:

The described technique facilitates the correction and transposition of the index ray.
Precise skeletal alignment is critical for successful reconstruction.
Preservation of the adductor pollicis muscle is vital for thumb-finger pinch.

Conclusions:

This surgical approach offers a method for addressing the complex index ray in cleft hand reconstruction.
The technique aims to prevent common long-term issues like radial deviation and flexion contractures.
Successful reconstruction can lead to improved hand function and pinch.