What is Floating Thumb?
Floating thumb is a unique type of thumb hypoplasia characterized by a very small and thin skin pedicle connecting the thumb to the palm. The thumb lacks bones or tendons connecting it to the main body of the palm, giving it a floating appearance.
What is Floating Thumb Surgery?
Floating Thumb Surgery reconstructs the ligaments in the thumb to stabilize the middle joint, improving function and stability by transferring a tendon from another part of the hand. The procedure may also involve releasing the tight web space between the thumb and index finger using a skin graft. Floating Thumb Surgery can be performed when the child is between 6 months and school age.
Methods of Floating Thumb Surgery:
Currently, there are three treatment options for floating thumb surgery:
- Pollicization of the Index Finger: This approach sacrifices the index finger to construct a new thumb.
- Partial Metatarsal Reconstruction: This involves transplanting half of the third or fourth metatarsal bone from the foot to reconstruct the first metacarpal and the first carpometacarpal joint.
- Partial Metacarpal Reconstruction: This method involves taking a portion of the second metacarpal bone from the child to rebuild the first metacarpal.
Comparison between Index Finger Pollicization and Partial Metacarpal Reconstruction:
- Index Finger Pollicization:
Index finger pollicization offers a relatively simple floating thumb surgery with faster recovery, but results in the child having only four fingers on the hand. Partial metatarsal reconstruction preserves all five fingers but requires 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 surgical scars on the foot.
- Partial Metacarpal Reconstruction:
Compared to traditional floating thumb surgery, partial metacarpal reconstruction offers 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 develop thumb functionality at an earlier age.
Why Choose Our Floating Thumb Surgery?
Dr. Jianghai Chen is MD in Surgery from Huazhong University of Science and Technology, Wuhan, China (2003) and PhD from Katholieke Universiteit Leuven, Belgium (2008), also Associate Professor/Chief physician of Hand Surgery, Wuhan Union Medical College Hospital, master supervisor.
Dr. Jianghai Chen's Academic Papers:
- Syndactyly release with the use of the Pelnac™ artificial dermal substitute without skin grafting. J Plast Reconstr Aesthet Surg. 2023 Sep;84:115-120.
- Acellular dermal matrix for one-stage treatment of lower extremity full-thickness skin defect: a case series. BMC Surg. 2023 Jan 24;23(1):17.
- Identification and validation of a ferroptosis-related gene signature for predicting survival in skin cutaneous melanoma. Cancer Med. 2022 Sep;11(18):3529-3541.
Floating Thumb Surgery Hospital Questions Guide:
FAQ
Q: How are thumb hypoplasia and aplasia diagnosed?
Q: What are the advantages of your Floating Thumb Surgery?
Thumb Preservation: The procedure preserves the child's thumb, maintaining as much of the original anatomy as possible.
No Need for Bone Grafting: It avoids the need to harvest bone from the child's foot, reducing additional surgical sites and potential complications.
Lower Risk of Complications: There is a reduced risk of bone absorption and necrosis, enhancing the likelihood of successful outcomes.
Early Intervention: Floating Thumb Surgery can be performed on children as young as 6 months to 1 year, allowing for earlier development of thumb functionality.
Q: What are the methods of Floating Thumb Surgery?
Pollicization: A finger, usually the index finger, is transferred to the thumb position to create a functional thumb. This surgery is often performed on children between 6 and 18 months old.
Reconstruction: This surgery can be beneficial for children with types 2 and 3 thumbs.
Carpometacarpal arthroplasty: This surgery can help retain the thumb while also acquiring function.
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