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Conjoined flexor and extensor pollicis longus tendons in the hypoplastic thumb

Insights

A rare congenital band between thumb tendons can cause hypoplasia. Surgical release improved function in children, highlighting this as a key consideration for absent extrinsic muscle function.

Area of Science:

  • Orthopedics
  • Pediatric Surgery
  • Anatomy

Background:

  • Congenital anomalous junctura tendinum between the flexor pollicis longus (FPL) and extensor pollicis longus (EPL) tendons is infrequently documented.
  • Thumb hypoplasia can present with apparent absence of extrinsic muscle function, necessitating thorough etiological investigation.

Observation:

  • An anomalous junctura was identified in three pediatric patients presenting with congenital thumb hypoplasia.
  • These patients exhibited limited thumb mobility and strength, suggestive of intrinsic muscle dysfunction.

Findings:

  • Surgical release of the anomalous FPL-EPL junctura led to significant improvement in thumb function in all affected children.
  • Histological examination confirmed the presence of fibrous connective tissue forming the anomalous band.

Implications:

  • The presence of a congenital anomalous junctura should be considered in the differential diagnosis of congenital thumb hypoplasia with apparent absent extrinsic muscle function.
  • Early surgical intervention for this condition can restore thumb functionality and improve patient outcomes.

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