Pollicisation of the index finger: A 27-year follow-up study

Abstract

We have reviewed 11 patients with congenital absence of the thumb, treated by pollicisation of the index finger, after follow-up for 20 to 38 years. Seven of the hands also had an associated radial club-hand deformity. Function as assessed by the Percival score was excellent in six, good in three, fair in two and poor in four; three of the poor results were in patients with radial club hand. Ten of the 15 transfers were used as normal thumbs, but in five hands function required trick movements. Of the seven unilateral cases, two transplants were used as the dominant hand, and in another two thumb strength was more than 50% of that on the opposite side. For patients with isolated congenital absence of the thumb, pollicisation of the index finger gives good functional and cosmetic results which are maintained. The results are less reliable for those with radial club hand.

Radial Deficiency

“…The functional results of pollicization in patients with RLD do not compare as well as those with isolated Blauth-type thumb hypoplasia when examined in long-term follow-up (Clark et al 1998;Molenaar et al 2013). De Kraker and colleagues examined the outcomes of 24 patients with varying degrees of RLD deficiency at greater than 9 years following pollicization.…”

Apport d’une technique originale de chirurgie conservatrice dans la prise en charge des hypoplasies du pouce de type IIIb : « l’allongement relatif-stabilisation de la colonne du pouce »

“…Pourtant, les études ayant fourni des résultats fonctionnels des pollicisations pour hypoplasies du pouce sont peu nombreuses [8,9,[11][12][13]. Beaucoup d'auteurs ont d'ailleurs souligné la difficulté de juger les résultats dans une population infantile.…”

Cahier des charges en vue d’améliorer l’aspect esthétique et fonctionnel de la pollicisation dans les différences congénitales. Propositions techniques

“…Notons les études de Clark et al [11], Manske et al [12], Ogino et Ishii [13], Roper et Turnbull [14]. La plupart des auteurs ont insisté sur la difficulté de juger les résultats dans une population infantile [11][12][13][14][15][16].…”