Millard Cottle Thumb Hook, Thumb Ring Grip

What the millard cottle thumb hook is

The millard cottle thumb hook is a fine nasal retraction hook that is worn on the thumb rather than gripped in the fist. A ring or thimble at the handle end takes the thumb, and the shaft runs forward from it to the prongs.

That changes where the effort goes. A hook held in the fingers is held by muscles that tire in a few minutes; a hook braced against the whole thumb is held by the arm. On an alar margin that has to stay under the same tension for the length of a step, that difference is the reason the pattern exists.

It carries two surgical names because two surgeons shaped it, Millard and Cottle, and catalogs write it both ways.

Key design features of this thumb hook

Four features, and the first one is the whole instrument.

• Thumb ring or thimble. A thumb hook is worn, not gripped, which is what steadies long traction.
• Fine prongs. Cut for the alar margin and the nostril rim, not for a body of tissue.
• Short shaft. The working end is close to the hand, so small movements stay small.
• The rest of the hand stays free. Fingers can hold something else while the hook stays put.

Millard cottle thumb hook size

This section is short, and it is short for a reason.

Our own record carries no prong width and no overall length for this pattern. Other catalogs publish figures of their own, including prong widths in the 8 to 18 mm range, and none of them is repeated here as ours. Ask and it will be measured.

Where a cottle thumb hook is used

A cottle thumb hook is reached for wherever fine traction has to be held for a while.

What the prongs hold, and what they do not

A fine hook has narrow limits and they are worth setting out rather than leaving to be found.

How the thimble hook compares with the rest of the family

Four of the rows below are our own. This pattern and two of the others share the ring idea, which makes the thimble hook family the most distinctive group in this category.

Materials and finish

Made from high quality medical grade stainless steel, satin finished so the operating light does not reflect off the shaft into the surgeon eye. The steel itself is made to a German specification. The ring edge is rolled, because a ring worn against a thumb for an hour will mark it if the edge is left square.

Care and sterilization

Clean with a soft brush under running water, working the prongs, the junction of shaft and ring, and the inside of the ring itself where a glove leaves debris, then rinse in deionized water and dry fully before autoclaving. Store in a rack or a tip guard so nothing rests on the points. Check that the ring has not been bent out of round, because a ring that no longer fits the thumb turns a worn instrument back into a gripped one.

Ordering and wholesale

Adas Instruments makes this pattern to order and supplies hospitals, surgical centers and distributors across the United States, Latin America, Europe and Asia. Bulk and wholesale pricing is available, and instruments held on backorder ship in 10 to 12 working days. Every instrument carries a three year replacement warranty against manufacturing defects. Certifications: CE. Production is controlled under an ISO 13485 quality management system.

Frequently asked questions

What is a thumb hook used for?

Holding fine tissue under steady traction while the other hand works. In a nasal set it is used on the alar margin, the nostril rim and the skin flaps around them, in rhinoplasty and in cleft lip repair. The thumb ring is what lets the traction stay constant instead of drifting as the fingers tire.

Why wear the hook instead of holding it?

Because the muscles are different. A pinch grip is held by small muscles in the hand and they fatigue within minutes. A ring worn on the thumb transfers the load to the forearm, which can hold the same position far longer without the tip wandering.

Is it the same as a Cottle thumb hook?

Yes. Catalogs write this pattern as a Millard, a Cottle or a Millard Cottle thumb hook, and some list it as a thimble hook. They are the same instrument and all of those names bring you to this page.

Single prong or double prong?

Both exist. A single prong takes the smallest possible bite and suits fixing one point; a double prong holds a flap in its plane and stops it rotating. Tell us which you want when you order, because our own record does not specify one.

Can it be used on mucosa?

No. The prongs are sharp and sharp points go through mucosa rather than holding it. For a mucosal surface take a blunt ball ended pattern instead, which presses on the tissue and slides off before it tears.

Related products and categories

Buyers who order the millard cottle thumb hook usually order alongside it the swivel ring double hook, the gruber columella retractor with weight and the martinez kilner nasal retractor. The whole family sits in hooks and retractors, and this pattern is also listed under rhinoplasty instruments.