2014, Number 1
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Acta Ortop Mex 2014; 28 (1)
Opening of the first web space in patients with multiple congenital arthrogryposis and adducted thumb with a dorsoradial index finger flap
Rodríguez-Ramos N, Capdevila-Leonori R, Nualart-Hernández L
Language: Spanish
References: 14
Page: 23-27
PDF size: 409.73 Kb.
ABSTRACT
Introduction: Arthrogryposis multiplex congenita is a progressive syndrome characterized by deformed and stiff joints, atrophy or absence of muscles, contracture and thickening of the capsular articular and periarticular tissue, and normal psychic status.
Material and methods: A retrospective, descriptive, evidence level III study was conducted on the surgical management of patients with Arthrogryposis multiplex congenita and congenital adducted thumb between January 2005 and December 2010. Twenty-seven opening procedures were performed in 16 patients with a dorsoradial index finger flap technique. In 80% of patients the dominant hand was operated first; patients included nine males and seven females; the operated hands included 15 right and 12 left hands.
Results: Flap design permits better advancement and space deepening, and cosmetic improvement. The mean preoperative first and second intermetacarpal angle was 20.5
o on average, with a minimum of 14
o and a maximum of 27
o. The mean postoperative first and second intermetacarpal angle was 50
o, with a minimum of 36
o and a maximum of 65
o. This was observed at the clinic with active thumb extension as well as proper thumb apposition.
Conclusions: Flap design permits better advancement and space deepening, with a better balance between flexors and extensors. All patients had better limb function and cosmetic improvement.
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