The windblown hand: correction of the complex clasped thumb deformity.
The complex clasped thumb deformity associated with a windblown hand requires correction of three distinct deficits: an adduction contracture of the thumb-index web space, a flexion-volar subluxation contracture of the thumb metacarpophalangeal joint, and severe hypoplasia of the superficial thenar muscles. Severe contractures of the thumb web space are best released by an extensive soft-tissue release and skin coverage with a large, dorsal ration-advancement flap. The thumb metacarpophalangeal joint flexion contracture is corrected by an extensive soft-tissue release, often accompanied by metacarpophalangeal joint fusion. An opponensplasty substitutes for the lack of thenar muscle. Correction of all of the deficits is required to achieve good thumb function.
McCarroll
H R
HR
University of California, San Francisco.
Manske
P R
PR
D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000601:surgery; D005500:Follow-Up Studies; D006228:Hand Deformities, Congenital / Q000601:surgery; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000002:abnormalities / Q000601:surgery; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods*; D013933:Thumb / Q000002:abnormalities / Q000601:surgery*; D016896:Treatment Outcome