A type i deformity is usually supple with absence or. Congenital clasped thumb congenital clasped thumb describes a spectrum of anomalies from minor deficiency of the extensor mechanism to severe abnormality of the thenar muscles, web space and soft tissues. Treatment of congenital clasped thumb in arthrogryposis h. Further followup on five cases of congenital clasped thumb, originally reported in 1955 11, is given, as well as our experience with twelve additional cases observed since that time.
Adducted thumb syndromes fitch 1975 clinical genetics. Type iii rigid clasped thumb clasped thumb that is associated with arthrogryposis and marked softtissue deficits. The views expressed in this article are those of the authors and do. Further followup on five cases of congenital clasped thumb, originally reported in 195511, is given, as well as our experience with twelve additional cases observed since that time. It can be difficult to assess for congenital clasped thumb in the first three to four. Hand deformities can be particularly disabling as the child learns to interact with the. Abdelwahed journal of hand surgery european volume 2017 42. Pubmed is a searchable database of medical literature and lists journal articles that discuss clasped thumbs, congenital. The characteristic position of the trigger thumb is a flexed position of the thumb. Jun 06, 2016 clasp thumb is often bilateral and, in my experience, is usually not associated with conditions like polydactyly. A 4yearold girl with congenital clasped thumb deformity due to absence of extensor pollicis brevis tendon.
Congenital clasped thumb thumb inpalm deformity congenital clasped thumb refers to a spectrum of thumb anomalies that range from mild deficiencies of the thumb extensor mechanism to severe abnormalities of the extrinsic and intrinsic muscles, web space, and soft tissue and joint contractures. Most newborns keep the thumb positioned in the palm for the first months of life and, therefore, the diagnosis may not be clear. Over a 10year period, 43 patients 75 hands with congenital clasped thumb were seen in our institution. Although the disease is rare, diagnosis is usually delayed due to natural location of thumb within the palm in first 3 months of life. Ulnar subluxation of the extensor pollicis longus tendon as a. The syndromes that include adducted thumb as a cardinal feature such as dundar syndrome are few in the literature.
Congenital clasped thumb in children pdf st georges hospital. However, radial polydactyly can have thumbs that dont straighten fully although, in my experience, this is typically different than clasped thumb. Of the 1% to 2% of babies born with congenital defects, 10% are born with malformations to the hand. Ulnar subluxation of the extensor pollicis longus tendon. Common congenital hand conditions chong a k s abstract congenital hand deformities are common but most of these conditions are minor. The mother notes that a few weeks ago the thumb would straigthen but when it did extend, the thumb would click and the child would occassionally cry and complain that the thumb hurt. This leaflet offers more information about the hand therapy treatment available for children with congenital clasped thumb. Thumb can be passively abducted and extended against resistance of thumb flexors. We report the result of treatment of 69 complex clasped thumbs in 39 patients with distal arthrogryposis. This course provided me with a variety of congenital and traumatic thumb conditions among the pediatric populations and therapeutic treatments to address each om an occupational therapy approach. Congenital hand deformities johns hopkins medicine.
These anomalies occur in early pregnancy and are sometimes diagnosed by ultrasound during pregnancy. A threeyearold male child presents with a right flexed thumb ip joint and a lump on the palm side of the thumb mp joint. This condition can be an isolated anomaly or associated with several genetic disorders. A simple splinting method for correction of supple. The aim of this study was to diagnose and evaluate cases of clasped thumb as regards the associated congenital anomalies and syndromes, and evaluation of the results of treatment of such cases. Aug 14, 2014 congenital clasped thumb is a heterogeneous group of disorders characterized by inability to actively extend the metacarpophalangeal joint of the thumb. Thomson and grace congenital adducted thumb the adducted thumb may present as an isolated anomaly or as part of a syndrome such as polands, turners, moebius, freemansheldon, and the congenital clasped thumb as described by weckesser et al 2. Article in press current orthopaedics 2006 20, 266273. Pdf congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital anomalies. There are variations in the size and form of the duplicated digit fig. Congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital anomalies.
Differentiating acquired trigger thumb from congenital clasped thumb is critical, especially if surgical correction is considered. An extra digit or polydactyly is one of the more common congenital hand conditions encountered in clinical practice. Deficient thumb extensor mechanism resulting in a flexed and adducted thumb in. Austin, tx pediatric hand surgery for congenital problems. Slakey, journalhand, year2012, volume7, pages191193 robert t. Inheritance is believed to be autosomal recessive, caused by mutation in the chst14 carbohydrate sulfotransferase 14. Clasped thumbs, congenital genetic and rare diseases. Congenital clasped thumb that is forgetten a syndrome in.
Characteristics of patients with congenital clasped thumb. Click on the link to view a sample search on this topic. Thumb, congenital clasped, with mental retardation symptoms, causes, diagnosis, and treatment information for thumb, congenital clasped, with mental retardation masa syndrome with alternative diagnoses, fulltext book chapters, misdiagnosis, research treatments, prevention, and prognosis. Congenital clasped thumb congenital hand and arm differences. Deficient thumb extensor mechanism resulting in a flexed and adducted thumb in infancy. Any type of deformity in a newborn can become a challenge for the child as he or she grows. This may occur with or without other digital anomaly. Congenital clasped thumb is characterized by a tightly flexed and adducted thumb in infancy. The aim of this study was to diagnose and evaluate cases of clasped thumb as regards the associated congenital anomalies and syndromes, and evaluation of the results of.
Sep 25, 2015 congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogenous congenital abnormalities. Austin, tx pediatric hand surgery for congenital problems and. This deformity is often reffered to as thumbclutched hand, but a better term is the congenital clasped thumb. Congenital clasped thumb thumb inpalm deformity congenital clasped thumb refers to a spectrum of thumb anomalies that range from mild deficiencies of the thumb extensor mechanism to severe abnormalities of the extrinsic and intrinsic muscles, web space, and soft tissue and joint. The original contributions consist of discussions of 1 the possible pathogenesis of adducted thumbs in the congenital clasped thumb syndrome and in sex. Weckesser, reac, and heiple called it a syndrome and divided the syndrome in to four groups. With age and an interest in grasping objects in the world, the clasped thumb becomes more apparent.
She has ventricular septal defect and left renal agenesis. It is like a short opponens splint that can keep the thumb in a position of abduction and extension without limiting wrist moveme. Several key features help to distinguish these two very different entities. Files are available under licenses specified on their description page. The congenital clasped thumb is associated with several welldefined syndromes, although it may also present as an isolated abnormality. If you have problems viewing pdf files, download the latest version of adobe reader. I certainly hope you are being cared for by an experienced congenital hand surgeon. Congenital clasped thumb disorder is a condition present at birth congenital where a child is born with one or both thumbs folded across the palm of the hand. Congenital clasped thumb presents as a flexion adduction deformity of the thumb.
Congenital clasped thumb is a heterogeneous group of disorders characterized by inability to actively extend the metacarpophalangeal joint of the thumb. It is primarily due to deficiency of thumbs extensors broadbent. Roughly 1 in every 10,000 births exhibit some form of thumb hypoplasia. View enhanced pdf access article on wiley online library html view. Congenital hand anomalies clasp thumb occupational therapy department the royal childrens hospital, melbourne, 2014. Purpose congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed in many congenital syndromes.
Congenital clasped thumb is characterized by a thumb that is strongly fixed at the metacarpophalangeal joint and adducted into the palm. Thumb malformation an overview sciencedirect topics. Congenital anomalies are hand or finger deformities that are present at birth. Congenital clasped thumb refers to a wide spectrum of thumb anomalies. In contrast to pediatric trigger thumb, congenital clasped thumb manifests as flexion at the thumb mp joint, but depending on involvement of the extensor pollicis longus tendon, flexion at the ip joint may be present. Congenital clasped thumb describes an anomaly which is characterized by a fixed thumb into the palm at the metacarpophalangeal joint in one or both hands. Abstractcongenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital anomalies.
Lynn bassini, mukund patel, in fundamentals of hand therapy, 2007. Anderson and breed 1981 suggested that the moro reflex may be a useful way to detect congenital clasped thumb early. May 04, 20 congenital clasped thumb may affect one or both thumbs but more commonly affects both. Treatment of congenital clasped thumb in arthrogryposis.
Pediatric trigger thumb, although somewhat controversial, appears to be an acquired condition and is typically unilateral 4, 79. A 15yearold male patient presented with difficulty extending his right thumb due to subluxation of the extensor pollicis longus epl tendon. Does my child need any tests to confirm the diagnosis. A splint has been designed to correct the congenital clasped thumb. Congenital clasped thumb describes a condition present at birth but potentially not recognized until 34 months of age or even later in which the thumb is flexed into the palm. Congenital clasped thumb is a flexionadduction deformity at the mp joint where the palmar surface of the thumb char acteristically rests tightly flexed against. The longterm results of treatment with corrective plaster casts have remained good if the early response was good. Pdf treatment of congenital clasped thumb in arthrogryposis. Physical examination showed that active motion of the thumbs metacarpophalangeal mp joint was 76 in flexion and 58 in extension. It is also common for the skin between the thumb and index finger to be tight in congenital clasped thumb making it difficult to stretch the thumb away from the hand.
Mar 01, 2020 pubmed is a searchable database of medical literature and lists journal articles that discuss clasped thumbs, congenital. Type ii clasped thumb with contracture thumb cannot be passively extended and abducted. Congenital clasped thumb may affect one or both thumbs but more commonly affects both. Thumb, congenital clasped, with mental retardation. Congenital clasped thumb and the report of 8 cases core. Nov 01, 2007 congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed in many congenital syndromes. Disease infosearch congenital clasped thumb definition. The longterm results of treatment with corrective plaster casts have remained good if. Christian, the first person to describe the condition. The pediatric thumb 3961 hand, upper extremity, and.
Home december 1964 volume 34 issue 6 flexionadduction deformity of the thumbcongenital clasped. Clasped thumb occurs in some families with xlinked hydrocephalus due to stenosis of the aqueduct of sylvius 307000. It can be a result of mild deficiencies of the thumb extensor mechanism extensor pollicis brevis or longus or both or severe abnormalities of the extrinsic and intrinsic muscles, web space and soft tissue and joint contractures 3. In this kind of disorder a child has a thumb, though it is always clasped inward toward the palm.
The commonest form of polydactyly is that of thumb duplication fig. Congenital clasped thumb is a deformity that is associated with heterogeneous congenital anomalies and it has been addressed in many. Definition of congenital clasped thumb with mental retardation. It is more accurate to view thumb polydactyly as a splitting of. Infants persistent thumbclutched hand, flexionadduction deformity of the thumb, pollex varus. Technique of thumb reconstruction in a case of complex clasped thumb in distal arthrogryposis. A 4yearold girl with congenital clasped thumb deformity due to absence of extensor pollicis brevis tendon whose treatment consisted of extensor. She has been wearing a splint for the last 6 months.
Congenital clasped thumb congenital flexionadduction. All structured data from the file and property namespaces is available under the creative commons cc0 license. Subluxation of the metacarpophalangeal joint, and hyperextensibility. Thumb hypoplasia refers to a variety of congenital abnormalities of the thumbs found in newborns, typically involving poor formation of the thumb. Also, it occurs to some degree in all patients with thumb duplication. Congenital clasped thumb that is forgetten a syndrome in clinical. Dec 04, 2018 home medterms medical dictionary az list congenital clasped thumb with mental retardation definition medical definition of congenital clasped thumb with mental retardation medical author. A 4yearold girl with congenital clasped thumb deformity due to absence of extensor pollicis brevis tendon whose treatment. This condition is caused by muscles and tendons forming incorrectly during fetal development tendons in the hand may have formed too short or not at all.