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Long-term functional results after pollicization for the congenitally deficient thumb
P R Manske1, M B Rotman, L A Dailey
1Division of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110.
The Journal of Hand Surgery
|November 1, 1992
Summary
Index finger pollicization offers functional benefits for congenital thumb deficiency, achieving 50% of normal thumb range of motion. While strength is reduced, 84% of patients use the pollicized digit for daily activities.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Pediatric orthopedics
Background:
- Congenital deficiency of the thumb requires reconstructive surgery.
- Index finger pollicization is a common surgical technique to address this deficiency.
Purpose of the Study:
- To objectively evaluate the functional outcomes of index finger pollicization.
- To provide data for counseling patients and families regarding expected results.
Main Methods:
- Retrospective review of 28 index finger pollicizations.
- Objective assessment of range of motion, grip, and pinch strength.
- Evaluation of functional use in defined activities and time to perform tasks.
Main Results:
- Average total active range of motion was 50% of a normal thumb.
- Grip and pinch strength were significantly reduced (21-26% of standard).
- 84% of patients used the pollicized digit in activities, with better performance for large objects.
Conclusions:
- Index finger pollicization provides functional restoration for thumb deficiency, though with limitations in strength.
- Outcomes are generally good, especially in patients without associated conditions like radial club hand.
- Surgical age does not appear to influence functional results.