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Six Cases of Angled Thumb in Children

Surgeons in Korea present the treatment and results for angular deformity in the thumbs of six children under the age of five. Photos of the children showed the tip of the thumb tilted toward the index finger.

All cases were caused by a triangular-shaped ossification (growth) center. Instead of an evenly square-shaped bone, a triangular corner piece of the growth plate is missing. The condition is called abnormal triangular epiphysis of the thumb. Treatment to correct the deformity is with an operation called a closing-wedge osteotomy.

A small pie-shaped piece of bone is wedged into the bone at the tip of the thumb. This bone is called the distal phalanx. The surgeon is careful to avoid the growth plate, cartilage, and tendons.

All children were followed for up to two years. Patients and parents were happy with the results. No one lost thumb motion and no damage was done to the growth plate. Only one patient still had a mild deformity. The surgeons say this was caused by under correction at the time of the original surgery.

The authors also describe three types of angled thumbs based on where the problem begins. Treatment for each type is reviewed based on the patient's age and X-ray results. Surgery is advised sooner than later for the best results.

References: Goo Hyun Baek, MD, et al. Abnormal Triangular Epiphysis Causing Angular Deformity of the Thumb. In The Journal of Hand Surgery. April 2006. Vol. 31A. No. 4. Pp. 544-548.

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