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Index finger pollicization for congenital aplasia or hypoplasia of the thumb

S H Kozin1, A A Weiss, J B Webber

  • 1Shriners Hospital for Crippled Children, Philadelphia, Pa.

The Journal of Hand Surgery
|September 1, 1992
PubMed

Insights

Index finger pollicization improves hand function for congenital thumb differences. While tip-to-tip pinch is most effective, many patients adapt to side-to-side pinch for prehension.

Area of Science:

  • Hand surgery
  • Pediatric orthopedics
  • Reconstructive surgery

Background:

  • Congenital absence or hypoplasia of the thumb significantly impacts hand function.
  • Index finger pollicization is a reconstructive surgical technique to address these conditions.

Purpose of the Study:

  • To evaluate the functional outcomes of index finger pollicization in patients with congenital thumb anomalies.
  • To assess sensation, strength, dexterity, length, and range of motion post-surgery.

Main Methods:

  • A cohort of 10 patients (14 hands) underwent index finger pollicization.
  • Functional outcomes including grip strength, pinch strength (lateral, palmar, three-point), and manual dexterity were measured.
  • Comparison was made with the contralateral normal hand and age/sex-matched standards.

Main Results:

  • Patients achieved an average of 67% grip strength and 70% manual dexterity compared to normal.
  • Pinch strength varied, with three-point pinch at 39% of normal.
  • 55% of patients utilized side-to-side pinch, achieving 54% of normal function, while tip-to-tip pinch users achieved 93%.

Conclusions:

  • Index finger pollicization offers significant functional improvement for congenital thumb differences.
  • Patient adaptation to different pinch strategies, particularly side-to-side pinch, impacts overall functional outcomes.
  • Optimizing prehension techniques post-surgery may further enhance functional recovery.

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