Formation of a Functional Thumb Post with Sensation in Phocomelia

Abstract

A two-and-one-half-year-old child with a congenital absence of the distal three-quarters of one hand was about to be fitted with a prosthetic appliance. Since carpal movement was excellent, a post-type of thumb was constructed (in three operative procedures) to which the palm could be approximated. The arrangement of the pedicle was such that the palmar side of the thumb was sensitive. Six years of follow-up find the child using the hand far beyond expectation. It surpasses any prosthetic appliance for mobility and grasp, but best of all, it has sensation. The recently discussed causitive relationship between thalidomide and phocomelia may produce similar anomalies which may be effectively corrected with this principle.