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In Snomed CT the thumb is not a finger and is therefor always separated from the fingers. In the Netherlands the care professionals consider the thumb as a finger, wich makes it difficult for us to translate these concepts. We found a way to do this, but we do have problems when there are concepts of finger and not with thumb and how to interpret these concepts.

For example:

427110004 |Structure of bursa of finger (body structure)| and there is no structure of bursa of thumb.

372168009 |Bone part of distal phalanx of finger (body structure)|, there is no thumb variant

For these examples I requested the thumb variant but I am sure there are more of these examples in Snomed

Another example are disorders and procedures

708866002 |Arthrotomy with drainage of joint of finger (procedure)| with procedure site finger structure

Strictly, you can't use this procedure when its performed on the thumb, because its not a finger in Snomed. But there is no Arthrotomy with drainage of joint of thumb (procedure)| in Snomed. Or do they actually mean digit here and should the procedure site change? 

In summary, in our opinion, it gets too complicated to model the finger-thumb-digits anatomy in this way. Are there more countries who are struggling with this? Wouldn't it be more useful to avoid the term/concept 'finger' and talk about digits and the distinct names of the digits? I hope to hear experiences of other countries how they deal or would deal with this issue.