58-293
Diagnóstico y tratamiento del pulgar en Z en edad pediátrica, a propósito de un caso.
Diagnosis and treatment of thumb in Z in pediatric age. A case report.
CARRATALÁ PÉREZ C, GÓMEZ BARBERO P, VILLAR BLANCO A, ESTEBAN PEÑA M SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA, HOSPITAL UNIVERSITARIO DOCTOR PESET, VALENCIA
Recepción:
20/03/2023
Aceptación:
20/03/2023
Publicación:
20/03/2023
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Resumen (ES)
Boutonniere deformity of the thumb or Z thumb consists in a flexion of the metacarpophalangeal joint and a
hyperextension of the interphalangeal joint. This deformity is typically associated with rheumatoid arthritis, although in
pediatric age it is usually congenital. Material and method: We present a 15-year-old male who was diagnosed with
boutonniere deformity of the thumb in a mild stage and was surgically treated by volar release of soft tissues and rerouting
of the extensor pollicis longus tendon, according to the Iwamoto technique. Discussion and conclusion: For the correct
treatment of this type of injury, it is essential to differentiate between a reducible deformity and a fixed one, as well as to
assess the state of the joint with imaging tests. In early stages with reducible deformities, the treatment is based on
reconstruction of the extensor apparatus. In more advanced phases, arthroplasty or arthrodesis should be used
hyperextension of the interphalangeal joint. This deformity is typically associated with rheumatoid arthritis, although in
pediatric age it is usually congenital. Material and method: We present a 15-year-old male who was diagnosed with
boutonniere deformity of the thumb in a mild stage and was surgically treated by volar release of soft tissues and rerouting
of the extensor pollicis longus tendon, according to the Iwamoto technique. Discussion and conclusion: For the correct
treatment of this type of injury, it is essential to differentiate between a reducible deformity and a fixed one, as well as to
assess the state of the joint with imaging tests. In early stages with reducible deformities, the treatment is based on
reconstruction of the extensor apparatus. In more advanced phases, arthroplasty or arthrodesis should be used
Palabras clave (ES):
en
Z
boutonniere
deformidad
retensado
Pulgar
Resumen (EN)
Boutonniere deformity of the thumb or Z thumb consists in a flexion of the metacarpophalangeal joint and a
hyperextension of the interphalangeal joint. This deformity is typically associated with rheumatoid arthritis, although in
pediatric age it is usually congenital. Material and method: We present a 15-year-old male who was diagnosed with
boutonniere deformity of the thumb in a mild stage and was surgically treated by volar release of soft tissues and rerouting
of the extensor pollicis longus tendon, according to the Iwamoto technique. Discussion and conclusion: For the correct
treatment of this type of injury, it is essential to differentiate between a reducible deformity and a fixed one, as well as to
assess the state of the joint with imaging tests. In early stages with reducible deformities, the treatment is based on
reconstruction of the extensor apparatus. In more advanced phases, arthroplasty or arthrodesis should be used
hyperextension of the interphalangeal joint. This deformity is typically associated with rheumatoid arthritis, although in
pediatric age it is usually congenital. Material and method: We present a 15-year-old male who was diagnosed with
boutonniere deformity of the thumb in a mild stage and was surgically treated by volar release of soft tissues and rerouting
of the extensor pollicis longus tendon, according to the Iwamoto technique. Discussion and conclusion: For the correct
treatment of this type of injury, it is essential to differentiate between a reducible deformity and a fixed one, as well as to
assess the state of the joint with imaging tests. In early stages with reducible deformities, the treatment is based on
reconstruction of the extensor apparatus. In more advanced phases, arthroplasty or arthrodesis should be used
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