Management of Congenial Clasped Thumb

• Conditions: Orthopedic Disorder
• Interventions: Procedure: widening of first web space

• Registration Number: NCT05212324
• Lead Sponsor: Al-Azhar University

Brief Summary

Congenital clasped thumb is a rare progressive flexion and adduction deformity presenting with heterogenous congenital abnormalities.(1, 2) It is confused with trigger finger deformity due to fixated flexion deformity of the thumb. In congenital trigger finger entrapment is present at A1 pulley level due to fusiform enlargement of flexor pollicis longus tendon

Detailed Description

The main problem is the deficient extensor tendon mechanism of thumb due to functional and structural causes. \\

Although in congenital clasp finger deformity there are thumb flexion deformity due to extensor tendon insufficiency and muscle and skin contractions at flexor and thenar regions.

In congenital clasped thumb success of treatment depends on lesion type. Although successful results have been obtained with splinting and conservative treatment, several reconstruction methods are used due to secondarily developed contractures in neglected cases. Tendon transfers are useful in hypermobile thumb cases who have both extensor and opponents tendon deficiency.

Study Timeline

• Status Verified: 2022-01
• Study First Submitted: 2022-01-11
• Study First Submitted QC: 2022-01-24
• Last Update Submitted: 2022-01-24
• Study First Posted: 2022-01-28
• Last Update Posted: 2022-01-28
• Study Start: 2022-02-11
• Primary Completion: 2024-01
• Study Completion: 2024-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. Congenital clasped thumb
2. Cerebral palsy
3. Arthrogryposis
4. Under age of eight years old.

Exclusion Criteria

• 1- Congenital trigger thumb. 2- Neglected adducted thumb. 3- Post traumatic extensor tendon injury. 4- Neglected congenital clasped thumb.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
widening	widening of first web space	widening of first web space by flaps, tendon transfer to extensor policis longus tendon, fractional lengthening of flexor policis longus tendon

Primary Outcome Measures

Name	Time	Method
improved hand grip degree	3 months	Measure the degree of thumb motion and improve function of the thumb to restore function of the hand abduction of the thumb more than 40 degree