Resumen

RODRIGUEZ-RAMOS, N; CAPDEVILA-LEONORI, R  y  NUALART-HERNANDEZ, L. Opening of the first web space in patients with multiple congenital arthrogryposis and adducted thumb with a dorsoradial index finger flap. Acta ortop. mex [online]. 2014, vol.28, n.1, pp.23-27. ISSN 2306-4102.

Introduction: Arthrogryposis multiplex congenita is a progressive syndrome characterized by deformed and stiff joints, atrophy or absence of muscles, contracture and thickening of the capsular articular and periarticular tissue, and normal psychic status. Material and methods: A retrospective, descriptive, evidence level III study was conducted on the surgical management of patients with Arthrogryposis multiplex congenita and congenital adducted thumb between January 2005 and December 2010. Twenty-seven opening procedures were performed in 16 patients with a dorsoradial index finger flap technique. In 80% of patients the dominant hand was operated first; patients included nine males and seven females; the operated hands included 15 right and 12 left hands. Results: Flap design permits better advancement and space deepening, and cosmetic improvement. The mean preoperative first and second intermetacarpal angle was 20.5^o on average, with a minimum of 14^o and a maximum of 27^o. The mean postoperative first and second intermetacarpal angle was 50^o, with a minimum of 36^o and a maximum of 65^o. This was observed at the clinic with active thumb extension as well as proper thumb apposition. Conclusions: Flap design permits better advancement and space deepening, with a better balance between flexors and extensors. All patients had better limb function and cosmetic improvement.

Palabras llave : arthrogryposis; joint; thumb; technic.