Bilateral Digital Extensor Hypoplasia Correction: A Case Report and Systematic Review.

Area of Science:

• Hand Surgery
• Pediatric Orthopedics
• Congenital Malformations

Background:

• Digital extensor hypoplasia (DEH) is a rare congenital malformation characterized by the loss of active finger extension at the metacarpophalangeal joints.
• Optimal treatment strategies and outcomes for DEH are not well-documented in medical literature.

Purpose of the Study:

• To describe the successful surgical management and outcomes of a pediatric patient with severe digital extensor hypoplasia.
• To highlight the efficacy of tendon transfer surgery in restoring finger extension and function in DEH.

Main Methods:

• Case report of a 5-year-old male with congenital DEH and severe bilateral finger extension limitation.
• Diagnostic workup included magnetic resonance imaging (MRI) to confirm extensor tendon hypoplasia/aplasia.
• Surgical intervention involved tendon transfers using the extensor carpi radialis longus to the common extensor tendons, with tenolysis on one hand.

Main Results:

• The patient demonstrated marked improvement in metacarpophalangeal joint position and active finger extension 2 years postoperatively.
• Restoration of functional grip strength and ability to grip objects without limitation was achieved.
• The patient returned to full unrestricted activity.

Conclusions:

• Tendon transfer surgery, potentially combined with tenolysis, is an effective treatment for digital extensor hypoplasia.
• Operative intervention can significantly restore finger extension, improve hand function, and enhance quality of life in affected children.