Correction of Congenital Clasped Thumb Deformity Type 1 & 2: A Case Series

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Author(s): 1.Hyder Ali, 2.Maryam Noor,3. Faiza Ambreen

Received: 02/07/2021 | Published: 11/08/2021 | Pages: 38-42 |

Congenital clasped thumb is a hereditary flexion and adduction deformity that is akin to a wide variety of structural abnormalities. Timely diagnosis of the deformity is critical for initiating treatment protocol and improving functionality of the hand. Objective: To discuss the treatment protocol of type 1 and type 2 clasped thumbs and their outcomes. Methodology: This prospective case series was conducted at Department of Plastic & Reconstructive surgery, Dow University of Health Sciences &Dr. Ruth K.M. Pfau Civil Hospital Karachi from June 2016 to May 2020.A total of 10 patients (16 thumbs) with Type 1 and Type 2 clasped thumb deformity were included; while 4 anomalous cases were excluded. Thorough family, pre-natal and ante-natal history and clinical examination were done. Involvement of unilateral/bilateral hand and disease severity wasnoted, and data was recorded on a proforma. Type 1 thumb with early presentation was given conservative treatment with splints. Type 2 thumb with web-space contractures was treated surgically with contracture release, tendon transfer and k-wires. Patients were followed for 12 months post treatment. Results: Out of 16 thumbstreatedin the study, 5 (31.3%) were given non- surgical treatment while 11 (68.7%) were given surgical treatment. Non-surgical treatment with splint alone was successful in 4 patients with satisfactory results, 1 thumb required surgical intervention later. All 11 thumbs subjected to surgical intervention showed improvement and satisfactory outcomes. 1 required re-correction later. Conclusion: Despite being a progressive disease, congenital clasped thumb can be managed successfully if timely diagnosis and treatment is initiated. The function of the hand can be drastically improved.Properly planned treatment gives satisfactory results.