Original communication
Pollex abductus in hypoplasia and duplication of the thumb,☆☆

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Abstract

Pollex abductus is an anomaly in which the flexor pollicis longus attaches not only at its customary insertion, but also into the extensor by a tendon that passes around the radial aspect of the thumb. Contraction of the anomalous flexor abducts the thumb. In the original report, the anomaly occurred in thumb hypoplasia. A similar anomaly is reported in 11 hypoplastic thumbs (35.5% of all cases) and in 9 cases of radial polydactyly (21.4%). The common feature was poor definition of the interphalangeal skin crease, with complete absence of active flexion of that joint. All patients were treated surgically; 13 before the age of 10 months, with correction of the duplication and the hypoplasia, and in the latter with elimination of the abduction deformity and restoration of opposition. The anomalous connection was excised in all patients. Active interphalangeal joint motion after reconstruction of the hypoplastic thumbs averaged 21 degrees.

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  • Cited by (31)

    • Variation of Extrinsic Tendons of the Thumb in Type IIIA Hypoplastic Thumbs

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      Citation Excerpt :

      There have been several reports on pollex abductus since Tupper’s2 paper. Manske et al1 reported that an interconnection was observed in 2 of 13 thumbs (15%), Lister4 reported one in 11 of 31 thumbs (36%), and Graham and Louis5 observed it in 14 of 14 thumbs (100%). Although these studies vary greatly from one another, our result, 50 of 79 thumbs (63%), was close to the average of previously reported values.

    • Management strategy for congenital thumb differences in paediatric patients

      2017, Orthopaedics and Traumatology: Surgery and Research
      Citation Excerpt :

      The clinical result is a decreased motion arc of the interphalangeal joint and, in some cases, abnormal posture. In pollex abductus, described by Lister [22] and Tupper [23], the hypoplastic thumb is deviated in the coronal plane due to abduction of the interphalangeal joint, which increases upon flexion of that joint. This clinical condition is due to abnormal attachments linking the extensor and flexor tendons.

    • Congenital abnormalities of the thumb

      2015, Journal de Pediatrie et de Puericulture
    • Reconstruction of the Hypoplastic Thumb

      2010, Journal of Hand Surgery
      Citation Excerpt :

      When the web space between the thumb and index is narrower than normal, the first element of reconstruction should be a soft tissue release that permits greater passive abduction of the thumb metacarpal. Less than 50° of web space spread between the thumb and index is considered inadequate.10 When web space narrowing is modest, a 4-flap z-plasty might be sufficient to provide exposure and increase the width of the first web space (Fig. 2).

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    Presented at the 44th Annual Meeting of the American Society for Surgery of the Hand, September 13–16, 1989, Seattle, Washington.

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    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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