Abductor digiti minimi myocutaneous flap for opponensplasty in congenital hypoplastic thumbs.
BACKGROUND
Although abductor digiti minimi transfer is a common form of opponensplasty for congenital hypoplastic thumbs, the inclusion of hypothenar skin with this flap--to create a myocutaneous flap--is not well-described.


METHODS
From a series of over 600 index pollicizations and hypoplastic thumb reconstructions performed from 1977 to 2007, 14 patients with congenital thumb hypoplasia are presented who had abductor digiti minimi myocutaneous flap transfer to improve thumb opposition. The primary indications for transfer were inadequate thumb opposition and aplastic palmar and thenar soft tissues. Follow-up ranged from 1 to 22 years.


RESULTS
All 14 transfers survived and were successful in improving thumb opposition. Key pinch strengths averaged 40 percent of normal. The inclusion of the skin paddle eliminated routing the muscle through tight palmar soft tissues while improving thenar bulk and appearance.


CONCLUSIONS
In select cases of congenital thumb hypoplasia, opponensplasty using the abductor digiti minimi myocutaneous flap is more advantageous than the traditional muscle transfer.
Upton
Joseph
J
Boston, Mass. From the Department of Plastic Surgery, Children's Hospital and Harvard Medical School.
Taghinia
Amir H
AH
D002648:Child; D006801:Humans; D018482:Muscle, Skeletal / Q000637:transplantation*; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013933:Thumb / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*