The false cortical thumb
R. R. Skoglund and E. E. Giles
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.
