Jianghai Chen

Floating thumb is a highly unique type of thumb hypoplasia. It is characterized by a very small and thin skin pedicle connecting the thumb to the entire palm. The thumb has no bones or tendons connecting it to the main body of the palm, resulting in a floating appearance.

 

Currently, there are three treatment options for floating thumb. The first follows the Western approach of pollicization of the index finger, sacrificing the index finger to construct a completely new thumb. The second involves partial metatarsal reconstruction, where half of the third or fourth metatarsal bone from the foot is transplanted to reconstruct the first metacarpal and the first carpometacarpal joint. The third option is partial metacarpal reconstruction, where a portion of the second metacarpal bone is taken from the child to rebuild the first metacarpal.

 

The advantages of index finger pollicization include relatively simple surgery and faster recovery for the child. However, the drawback is that the child is left with only four fingers on the hand. Partial metatarsal reconstruction preserves all five fingers but has the disadvantage of a three-month period during which the child cannot bear weight on the foot. There is also a risk of bone absorption and necrosis, along with the presence of surgical scars in the foot.

 

After years of research and clinical practice, the method of using partial metacarpal reconstruction to treat floating thumb has been developed in China. Compared to traditional treatment options, partial metacarpal reconstruction for floating thumb has several advantages. Firstly, it preserves the child's thumb. Secondly, it eliminates the need to take bone from the child's foot. Thirdly, it has a lower risk of bone absorption and necrosis. Lastly, children can undergo the surgery between 6 months and 1 year, allowing them to establish thumb functionality at an earlier age.

 

 

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