case_images: PMC6409146_01
case_images: Volar (A) and dorsal (B) preoperative photographic views of a 5-year-old girl with a non-usable right thumb since birth.
case_images: wjps-8-097-g001.jpg
case_images: PMC6409146_01_wjps-8-097-g001.jpg
case_images: F1
case_images: On physical exam, the patient had a small and thin right thumb when compared to the left (Figure 1A and B).
case_images: AP intra-operative x-rays demonstrate aplasia of the radial portion of the carpus with a hypoplastic first metacarpal
case_images: wjps-8-097-g002.jpg
case_images: PMC6409146_01_wjps-8-097-g002.jpg
case_images: F2
case_images: Intra-operative x-rays demonstrate aplasia of the radial portion of the carpus with a hypoplastic first metacarpal (Figure 2).
case_images: A W-plasty was performed to deepen the web space between the thumb and index finger to enhance thumb abduction, pinching, and grasping
case_images: wjps-8-097-g003.jpg
case_images: PMC6409146_01_wjps-8-097-g003.jpg
case_images: F3
case_images: At the initial procedure, a longitudinally placed W-plasty was performed to deepen the web space between the thumb and index finger (Figure 3).
case_images: Harvest of abductor digiti minimi by transection of its distal insertion at the base of the fifth proximal phalanx for use in Huber Transfer Oppopensplasty
case_images: wjps-8-097-g004.jpg
case_images: PMC6409146_01_wjps-8-097-g004.jpg
case_images: F4
case_images: The muscle was then inverted in the same manner as turning the page of a book (Figure 4).
case_images: After the first stage of the reconstruction, the patient is able to oppose her thumb of her right hand to the middle finger without difficulty
case_images: wjps-8-097-g005.jpg
case_images: PMC6409146_01_wjps-8-097-g005.jpg
case_images: F5
case_images: The previous surgical procedures enabled the child to tip pinch from the thumb to the index and long fingers (Figure 5).
case_images: A mini Stryker distraction lengthener for digits was attached to the thumb metacarpal bicortically. The device was turned 1 mm/day for three months to achieve a length of 4 cm
case_images: wjps-8-097-g006.jpg
case_images: PMC6409146_01_wjps-8-097-g006.jpg
case_images: F6
case_images: First, the mini Stryker (Kalamazoo, MI) distraction lengthener for digits was placed into its most compressed position (Figure 6).