Question 56#

Thumb hypoplasias are frequently associated with:

A. Scaphoid anomalies

First web space tightness. Thumb hypoplasias are often associated with a narrow/tight first webspace. They are associated with phalangeal and occasionally metacarpal anomalies, but not scaphoid. They are treated according to severity, and in severe cases are treated by pollicisation not toe transfer. Weckesser classified clasped thumb, not hypoplasia.

Question 57#

In pollicization:

A. The metacarpal head becomes the new trapezium

Question 58#

In thumb duplication:

A. Always reconstruct the ulnar collateral ligament of the MCP joint

Always look for pollex abductus. Pollex abductus is an anomaly in which FPL attaches not only at its customary insertion, but also into the extensor by a tendon that passes around the radial aspect of the thumb. It is of higher incidence in cases of thumb duplication.

Question 59#

The treatment of choice for a Blauth grade 3b hypoplastic thumb would be:

A. Toe transfer

Pollicization. In these, there is absence and instability of the proximal thumb metacarpal, and pollicization is widely recommended.

Question 60#

In a typical cleft hand:

A. There are finger nubbins

Is associated with autosomal dominant inheritance. Finger nubbins are seen in symbrachydactyly (previously known as atypical cleft hand), not in typical cleft hand. There is no preference for the left hand and usually there is a poor thumb but reasonable function.