Purpose
This study was conducted to report the functional outcomes of the Huber opposition
transfer (abductor digiti minimi muscle) in types II and IIIA hypoplastic thumbs.
Methods
Patients who had undergone a Huber opposition transfer with at least 5 years of follow-up
were included in this study. There were 21 thumbs included; 12 returned for a detailed
evaluation and 9 were included with a medical record review. Outcome measures included
range of motion and pinch strength; Pediatric Outcomes Data Collection Instrument
(PODCI) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores
were collected on those who could return. There were 15 type II and 6 type IIIA thumbs.
Results
Range of motion was significantly less than normal for both the interphalangeal and
the metacarpophalangeal joints. For the returning cohort, key and tripod pinch were
44% and 65% of normal. The median Kapandji score was 9 (range, 6–10). The PODCI scores
were high for global, upper extremity function, happiness, and pain. The PROMIS scores
were similar to normal, except for parent reports of physical function. For all included
patients, there was a revision surgery rate of 22%, primarily related to persistent
instability.
Conclusions
At a minimum 5-year follow-up, the Huber opposition transfer for types II and IIIA
thumbs was shown to provide good subjective outcomes, despite limited range of motion
and strength.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: May 04, 2017
Accepted:
March 30,
2017
Received:
September 14,
2016
Footnotes
This publication was supported by the Washington University Institute of Clinical and Translational Sciences grants UL1 TR000448 from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
