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(flexus adductus)
Thumb
• Very rare
• IP extension deficit
sometimes (EPL)
• Trigger thumb
Weckesser EC, Reed JR, Heiple KG (1968). Congenital clasped thumb (congenital flexion-adduction deformity of the
thumb). JBJS Am, 50A: 1417-1428.
Tsuyuguchi Y et al. Congenital clasped thumb. A review of 43 cases. J Hand Surgr 1985;10A:613-618.
Preferred classification
McCarroll Jr HR. Congenital flexion deformities of the thumb. Hand Clin 1985;1:567–75.
Mih AD. Congenital clasped thumb. Hand Clin 1998;14:77–84.
Evaluation of results (Weckesser)
• Excellent (no limitation of active extension of either the
metacarpophalangeal or interphalangeal joint),
Weckesser EC, Reed JR, Heiple KG (1968). Congenital clasped thumb (congenital ̄exion-adduction deformity of the
thumb). JBJS Am, 50A: 1417-1428.
Non-operative treatment
• Splinting in extension and
abduction (in type 1 patients)
Lin SC et al. A simple splinting method for correction of supple congenital clasped thumb in infants. JHS Br
1999;24B(5):612-614.
Miura T. Flexion deformities of the thumb. In: Buck-Gramcko D, editor. Congenital malformations of the hand and
forearm. London: Churchill Livingstone; 1998. p. 425–9.
Surgery is made stepwise
• Volar incision
• Web Z-plasty
• FPL lengthening
Surgery is made stepwise
• Dorsal incision
• Reconstruction of APL
with a tendon graft
• Recontruction of extensors
using ECRL, FDS IV, EIP
Mahmoud M, Abdel-Ghani H, Elfar JC. New Flap for Widening of the Web Space and Correction of Palmar
Contracture in Complex Clasped Thumb. (J Hand Surg 2013;38A:2251-2256.)
Conclusion