Evaluation of the first web-space narrowing in XXXX with Z-deformity.

@entity1 @entity154 @entity8886 @entity8482
BACKGROUND: In @entity1 with @entity154 of the thumb, the metacarpophalangeal joint often undergoes radial deviation to compensate for a narrow first web space. In this study, we evaluated the relationship between the thumb and index finger in @entity1 with @entity8482 ( @entity8482 ), by measuring the thumb-index angle on radiographs taken while the @entity1 held a @entity8886 foam cone. METHODS: Investigation was carried out on nine @entity1 (13 cases: four bilateral and five unilateral) with @entity8482 . The average @entity1 age was 4.4 years (range, 2.6-7.2 years). Overhead radiographs were obtained while the @entity1 held a @entity8886 foam cone. The radiographs were used to evaluate the apparent thumb-index web angle, the thumb to index finger metacarpal angle (1-2MCA), and the first metacarpophalangeal angle (1MPA). RESULTS: In the five unilateral cases, significant differences were seen on the affected versus unaffected sides in 1-2MCA and 1MPA. All 13 cases were treated surgically, and significant differences were observed between the groups before surgery and 2 years after surgery in the 1-2MCA and 1MPA. In addition, the mean postoperative 1MPA in the bilateral cases was significantly smaller compared with the unilateral cases. CONCLUSIONS: This radiographic technique enabled us to evaluate the severity of the thumb-index web-space narrowing and the radial instability of the thumb metacarpophalangeal joint in @entity1 with @entity8482 . The bilateral cases tended to show better rehabilitative improvement compared with the unilateral ones, probably because the latter @entity1 could use their unaffected hand.
