Global assessment of pollicization outcomes: an analysis in 27 patients

Abstract

Outcomes measurements after pollicization remains difficult due to the lack of a standardized assessment protocol. This study reports our experience of a global assessment of pollicized thumbs that includes a specific questionnaire for subjective evaluation, a detailed clinical assessment focused on functional outcomes incorporating function and usage of the pollicized thumb. Twenty-seven patients completed the questionnaire, and nine hands were clinically evaluated by a multidisciplinary team composed of hand surgeons and occupational therapists. Subjective evaluations revealed that 24 patients would recommend pollicization. Clinical evaluations revealed that only four out of nine patients properly integrated their pollicized thumb during bimanual activities; however, occupational therapy input allowed the children to compensate for the lack of strength and other difficulties. We propose the use of this global assessment package to analyse function and usage at various capacities, which can be useful for the surgeon, child and parents. Level of evidence: IV

An Alternative Treatment Option for Blauth III B Thumb Hypoplasia—Thumb Stabilization with Iliac Crest Bone Graft and Intermetacarpal Arthrodesis

“…Patients in the cohort described above had an average Kapandji score of 3.1, meaning they were able to reach the ring finger. In comparison to Bachy et al [ 24 ], who performed a follow-up of patients with pollicization and measured an average Kapandji score of 6, and Kollitz et al [ 25 ], who reported an average Kapandji score of 6.4 in patients who had also undergone pollicization, the results described above are of course worse due to the fixed position of the thumb.…”

Long-term results of index finger pollicization for congenital thumb anomalies: a systematic review

“…Despite being the most commonly used postoperative assessment test for pollicized thumbs, Bachy et al (2021) criticized the Percival score as not accurately reflecting the everyday function of the new thumb and overestimating postoperative outcomes. They also acknowledged the lack of standardized assessment measures in the literature and proposed a new method of assessment for index finger pollicization: a functional and aesthetic patient-oriented questionnaire and a bimanual coordination test for evaluation.…”

“…Range of motion in terms of either total motion of all joints of the new thumb or abduction and opposition was reported in three studies (Bachy et al, 2021;Tan and Tu, 2013;Vekris et al, 2011). Bachy et al (2021) reported a mean abduction of 51 and a mean opposition of 84 . A mean total motion of 138 and 123 was reported by Tan and Tu (2013) and Vekris et al (2011), respectively.…”

“…Va ´zquez Rueda et al (2001 reported no complications in their study. Bachy et al (2021) reported psychological distress in 5/27 and a sense of disability in 3/27 of their patients. All patients (n ¼ 15/15) underwent opponensplasty with the flexor digitorum superficialis of the ring finger and abductor digiti minimi tendons to achieve functionality during pollicization in the study by Tan and Tu (2013).…”

“…Hand function in terms of grasping, lateral pinching, tip pinching and strength was reported in six studies and further quantified in five of them (Aliu et al, 2008;Bachy et al, 2021;Clark et al, 1998;Tan and Tu, 2013;Va ´zquez Rueda et al, 2001;Vekris et al, 2011). Bachy et al (2021) reported the integration of the new thumb into the hand function. Complete integration was found in 83% (10/12) for large ball grip and 75% (9/12) for extension grip.…”