Results of pollicization in the management of hypoplastic thumb

ABSTRACT

In this study 27 pollicizations were done in the hands of 27 patients with hypoplastic thumbs. Seventeen with hypoplastic thumb type IV and V, 9 congenital radial club hands with absent thumb and one patient with mirror hand. Sixteen were females and 11 were males with an average age of 12 months [range 8-18]. Different syndromes as VATER, TAR and Holt-Oram were recorded with such condition. The technique used for pollicization was that described by Buck Gramcko and modified by Lister. Patients were followed up for a mean of 12 months [range from 8-24]. All hands were assessed according to parent satisfaction, degree of thumb movements and quality of skin of the first web space. Most parents were satisfied with the appearance and noticed improvement of the function of the operated hand of the child in the daily activities. The degree of abduction and rotation reached by the new thumbs was averagely 40 degrees and 100 degrees respectively. All patients used the pollicized thumb to grasp objects. We have described a scoring system to evaluate the results in such patients. There were no major complications as ischemia and loss of the new thumb. We concluded from this work that surgery for such cases was worthy. It definitely improved the cosmetic appearance and the function of the hand