Open Access
CC BY 4.0 · Arch Plast Surg 2023; 50(02): 177-181
DOI: 10.1055/s-0042-1757311
Hand/Peripheral Nerve
Case Report

Bilateral Digital Extensor Hypoplasia Correction: A Case Report and Systematic Review

Marudeen Aivaz 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Esperanza Mantilla-Rivas 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Ashleigh Brennan 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
John Thomas 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Elizabeth L. Malphrus 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Monica Manrique 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Albert K. Oh 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
,
Gary F. Rogers 
1   Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia
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Funding None.
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Abstract

Digital extensor hypoplasia (DEH) is a rare malformation that presents with loss of active finger extension at the metacarpophalangeal (MCP) joints. Descriptions of optimal treatment and outcomes in this population are sparse. We describe successful operative treatment of a child with DEH involving the extensor digitorum communis, extensor digiti minimi, and the extensor indicis proprius tendons. The 5-year-old male patient was referred for severe limitation on bilateral finger extension since birth. He had been previously diagnosed with arthrogryposis and managed conservatively. Due to lack of improvement, magnetic resonance imaging was done evidencing hypoplasia/aplasia of the extensor tendons. The patient underwent successful tendon transfers using extensor carpi radialis longus to the common extensor tendons, and one hand required an additional tenolysis procedure. 2 years postoperatively, his MCP position and finger extension are markedly improved, and he is able to grip objects without limitation or difficulty. The patient returned to full activity without restriction.

Keywords

extensors tendons - congenital hypoplasia - extensor retinaculum - extensor tendon transfer

Author Contributions

M.A, A.B, J.T., and E.L.M did the literature search and drafted part of the manuscript. E.M.R and M.M. collected case information, provided insight about the research design and drafted part of the manuscript. A.K.O. and G.F.R. revised the manuscript critically. All authors contributed significantly to the creation of this paper and approved the final manuscript.


Prior Presentation

This article was previously presented as Digital Extensor Hypoplasia Misdiagnosed as Arthrogryposis: A Case Report and Systematic Review at VASPS, Biennial meeting, November 22–23, 2019.


Patient Consent

The patient's mother provided consent to publish anonymized images and clinical characteristics of this case.


Ethical Approval

A waiver of this case report was obtained by the Children's National Hospital Institutional Review Board.




Publication History

Received: 21 January 2022

Accepted: 11 August 2022

Article published online:
01 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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