PMC6304831_01
A 5-year-old boy with a hypoplastic thumb.
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At this time, his right hypoplastic thumb was more prominent (Figure 1).
Radiographs demonstrating the type IIIB hypoplastic thumb.
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X-ray images revealed hypoplasia of the metacarpal bone and the defective CMC joint of the right thumb (Figure 2).
The metatarsal bone cut hemilongitudinally: (a) the cut metatarsal bone and (b) radiograph after the removal of the fourth metatarsal bone.
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During surgery, the left fourth metatarsal bone was cut hemilongitudinally from the head to the shaft and the lateral part was removed (Figures 3(a) and 3(b)).
The metatarsal bone transplanted into the metacarpal bone. (a) The metacarpal bone and the cut metatarsal bone were sutured. (b) These were fixed with a Kirschner wire.
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These were sutured with 5-0 polydioxanone sutures (PDS , Ethicon) (Figure 4(a)) and fixed with a 0.8 mm Kirschner wire from the distal site (Figure 4(b)).
Radiographs of 2 years of follow-up: (a) hand and (b) foot.
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The epiphyseal line was observed, and the metacarpal bone grew to approximately 28 mm in length within 2 years of surgery (Figure 5(a)). Moreover, readily notable growth disorder of the donor toe was not observed (Figures 5(b) and 6(b)).
Two years after surgery: (a) hand and (b) foot.
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The growth of the right thumb was confirmed via gross observation (Figure 6(a)), and the right thumb had stabilized, thereby enabling pinch and opposition.
He can push the buttons on a portable game machine.
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He can hold a pen and push the buttons on a portable game machine. (Figure 7).