Clasped Thumb

Chapter 35 of Volume 1, Hand & Upper Limb. Revision notes for the FRCS (Plast).

What this chapter covers

• Clinical Examination
• Treatment Strategy
• 1. Non-operative (First-line for Type I and early Type II)
• 2. Surgical Intervention
• Surgical Goals
• Surgical Techniques
• A. First Web Space Release
• B. Extensor Tendon Reconstruction
• C. Arthrodesis
• The Case & Describing the Thumb
• Q. Please describe this thumb.
• 1. Essentials
• 2. Pathoanatomy
• 3. Classification (know all three)
• 4. Syndromic Associations & the L1/MASA Syndrome (8-level)
• 5. Differential Diagnosis
• 6. Management
• Non-operative (first-line for supple / Tsuyuguchi I-II, Weckesser I)
• Surgery - goals: restore active extension, open the first web, restore abduction/ opposition
• 7. How to Score Highest in This Station
• 8. Higher-Level Discriminator Pearls