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April 1986, Vol 140, No. 4 >
Article | April 1986

The False Cortical Thumb FREE

R. R. Skoglund, MD; E. E. Giles, MD
[+] Author Affiliations

Accepted for publication Jan 13, 1986.

The opinions or assertions expressed herein are those of the authors and do not necessarily reflect the views of the Department of the Navy or the naval service at large.

Reprint requests to Children's Hospital, Division of Neurology, San Diego, CA 92123 (Dr Skoglund).


Am J Dis Child. 1986;140(4):375-376. doi:10.1001/archpedi.1986.02140180109037.
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• Two cases of thumb-in-palm deformity are presented that are postulated to be complications of repeated radial artery puncture and cannulation with secondary damage to the thumb extensor tendon sheath and its extensor pollicis brevis and abductor pollicis longus tendons. Nonfixed adduction-flexion posturing of the thumb is to be differentiated from "the cortical thumbs" often associated with adduction, flexion contracture of upper motor neuron injury, and other disorders with thumb-in-palm deformities. The risks of complication of radial artery puncture are multiple. An added risk is the potential for impaired extensor tendon function as a complication of a radial puncture.

(AJDC 1986;140:375-376)

REFERENCES

1 +
Matev I:  Surgical treatment of spastic 'thumb-in-palm' deformity . J Bone Joint Surg Br 1963;;45:703-708.
2 +
House JH, Gwathmey FW, Fidler MO:  A dynamic approach to the thumb-in-palm deformity in cerebral palsy . J Bone Joint Surg Am 1981;;63:216-255.
3 +
Allen EV:  Thromboangiitis obliterans: Methods for diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases . Am J Med Sci 1929;;178:237-244.
4 +
Flatt A: The Care of Congenital Hand Anomalies . St Louis, CV Mosby Co, 1977;.
5 +
Temtamy S:  The genetics of hand malformation . Birth Defects 1978;;14:3.
6 +
Neviaser RJ:  Congenital hypoplasia of the thumb with absence of the extrinsic extensors, abductor pollicis longus, and thenar muscles . J Hand Surg 1979;;4:301-303.
7 +
Lipscomb PR:  Tenosynovitis of the hand and the wrist: Carpal tunnel syndrome, de Quervain's disease, trigger digit . Clin Orthop 1959;;13:164-180.
8 +
Marshall G, Edelstein G, Hirshman CA:  Medial nerve compression following radial artery puncture . Anesth Analg 1980;;59:953-954.
9 +
Koenigsberger MR, Moessinger AC:  Iatrogenic carpal tunnel syndrome in the newborn infant . J Pediatr 1977;;91:443-445.
10 +
Mandel MA, Dauchet PT:  Radial artery cannulation in 1,000 patients: Precautions and complications . J Hand Surg 1877;;2:482-485.
11 +
Todres ID, Rogers MC, Shannon DC, et al:  Percutaneous catheterization of the radial artery in the critically ill neonate . J Pediatr 1975;;87: 273-275.
12 +
Cole FS, Todres ID, Shannon DC:  Technique for percutaneous cannulation of the radial artery in the newborn infant . J Pediatr 1978;;92: 105-107.
13 +
Russell JA, Joel M, Hudson RJ, et al:  Prospective evaluation of radial and femoral artery catheterization sites in critically ill adults . Crit Care Med 1983;;11:936-939.
14 +
Adams JM, Rudolph AJ:  The use of indwelling radial artery catheters in neonates . Pediatrics 1975;;55:261-265.
15 +
Bedford RF, Wollman H:  Complications of percutaneous radial-artery cannulation: An objective prospective study in man . Anesthesiology 1973;;38:228-236.

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References

1 +
Matev I:  Surgical treatment of spastic 'thumb-in-palm' deformity . J Bone Joint Surg Br 1963;;45:703-708.
2 +
House JH, Gwathmey FW, Fidler MO:  A dynamic approach to the thumb-in-palm deformity in cerebral palsy . J Bone Joint Surg Am 1981;;63:216-255.
3 +
Allen EV:  Thromboangiitis obliterans: Methods for diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases . Am J Med Sci 1929;;178:237-244.
4 +
Flatt A: The Care of Congenital Hand Anomalies . St Louis, CV Mosby Co, 1977;.
5 +
Temtamy S:  The genetics of hand malformation . Birth Defects 1978;;14:3.
6 +
Neviaser RJ:  Congenital hypoplasia of the thumb with absence of the extrinsic extensors, abductor pollicis longus, and thenar muscles . J Hand Surg 1979;;4:301-303.
7 +
Lipscomb PR:  Tenosynovitis of the hand and the wrist: Carpal tunnel syndrome, de Quervain's disease, trigger digit . Clin Orthop 1959;;13:164-180.
8 +
Marshall G, Edelstein G, Hirshman CA:  Medial nerve compression following radial artery puncture . Anesth Analg 1980;;59:953-954.
9 +
Koenigsberger MR, Moessinger AC:  Iatrogenic carpal tunnel syndrome in the newborn infant . J Pediatr 1977;;91:443-445.
10 +
Mandel MA, Dauchet PT:  Radial artery cannulation in 1,000 patients: Precautions and complications . J Hand Surg 1877;;2:482-485.
11 +
Todres ID, Rogers MC, Shannon DC, et al:  Percutaneous catheterization of the radial artery in the critically ill neonate . J Pediatr 1975;;87: 273-275.
12 +
Cole FS, Todres ID, Shannon DC:  Technique for percutaneous cannulation of the radial artery in the newborn infant . J Pediatr 1978;;92: 105-107.
13 +
Russell JA, Joel M, Hudson RJ, et al:  Prospective evaluation of radial and femoral artery catheterization sites in critically ill adults . Crit Care Med 1983;;11:936-939.
14 +
Adams JM, Rudolph AJ:  The use of indwelling radial artery catheters in neonates . Pediatrics 1975;;55:261-265.
15 +
Bedford RF, Wollman H:  Complications of percutaneous radial-artery cannulation: An objective prospective study in man . Anesthesiology 1973;;38:228-236.

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