Scientific article
Pollicization for Congenital Thumb Aplasia Using the Second Dorsal Metacarpal Artery as the Vascular Pedicle: Case Report

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The author presents the case of a child with bilateral thumb hypoplasia. Pollicization of the left index finger with grade 4 thumb hypoplasia was attempted and abandoned, apparently because of anomalous vascular anatomy. A secondary procedure identified a substantial second dorsal metacarpal artery that connected with a palmar-ulnar digital vessel at the level of the metacarpal neck. Successful pollicization was performed using the second dorsal metacarpal artery and its venae comitantes as the vascular pedicle.

Section snippets

Case Report

A 6-year-old boy with Rothmund-Thomson syndrome presented for assessment of bilateral radial ray deficiencies. Rothmund-Thomson syndrome is an autosomal recessively inherited disorder associated with mutation in a RECQL-4 helicase gene at the 8q24.3 locus, and it is characterized by small stature, poikiloderma, sparseness of hair formation, and juvenile cataracts. Radial deficiencies, cleft palate, and syndactyly frequently accompany this condition. There is an increased incidence of skin and

Discussion

Germann and colleagues3 described an adult case of pollicization based on the first dorsal metacarpal artery after trauma. It was not possible to replant a crushed thumb. The digital vessels to the index finger had been avulsed from the superficial palmar arch. However, the index finger remained viable through its dorsal vascularity. The authors performed a pollicization based on the first dorsal metacarpal artery. It is not documented whether the second dorsal metacarpal artery also had a role

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