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Extensor pollicis brevis reconstruction using the extensor digitorum proprius tendon through the first dorsal
Hiroaki Takeya1, Takehiko Takagi2
1Division of Orthopaedic Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
Insights
Surgical reconstruction of the extensor pollicis brevis (EPB) using the extensor indicis proprius (EIP) tendon effectively treated a clasped thumb deformity in an adolescent, restoring thumb function and relieving pain.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Pediatric Orthopedics
Background:
- Clasped thumb involves thumb adduction and flexion deformity due to extensor tendon abnormalities.
- Conservative treatments suffice for infants, but surgery is indicated for older patients with functional impairments.
- Adolescents with untreated clasped thumb may require surgical correction for deformities.
Purpose of the Study:
- To report the efficacy of extensor pollicis brevis (EPB) reconstruction using the extensor indicis proprius (EIP) tendon in an adolescent with a clasped thumb.
- To evaluate the functional outcomes and pain relief following this specific surgical technique.
Main Methods:
- A case report detailing an adolescent patient with an untreated right clasped thumb deformity and pain.
- Surgical intervention involved EPB reconstruction by routing the EIP tendon through the first dorsal compartment.
- Follow-up was conducted for 1 year and 6 months post-surgery.
Main Results:
- The patient experienced significant improvement in right thumb function.
- Increased range of motion and strength of the thumb were observed.
- Preoperative pain associated with the clasped thumb was completely relieved.
Conclusions:
- Extensor pollicis brevis (EPB) reconstruction utilizing the extensor indicis proprius (EIP) tendon passed through the first dorsal compartment is a viable treatment option for adolescent clasped thumbs.
- This surgical approach effectively reconstructs EPB function, leading to improved thumb mechanics and patient-reported pain relief.
Abstract:
Clasped thumb is characterised by thumb adduction and flexion deformity at the metacarpophalangeal joint caused by abnormalities in the extensor tendons. While conservative treatments are effective in infants, surgical intervention is necessary for older who experience deformities or functional impairments. We report an adolescent patient with an untreated clasped thumb who underwent extensor pollicis brevis (EPB) reconstruction using the extensor indicis proprius (EIP) tendon through the first dorsal compartment. The patient suffered from a right thumb deformity and pain. EPB reconstruction was performed by passing the EIP tendon through the first dorsal compartment. After 1 year and 6 months of follow-up, the patient's right thumb function significantly improved, with an increased range of motion and strength of the thumb, and the preoperative pain was relieved. EPB reconstruction using EIP passing through the first dorsal compartment for clasped thumbs in adolescents can reconstruct the EPB function appropriately and is a possible treatment option.
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