Outcome of index finger pollicisation

Pollicisation of the index finger for absence or severe hypoplasia of the thumb has been reported as a good procedure to recreate a new 'thumb' with good cosmesis and acceptable function. The purpose of this study is to evaluate the outcome of our series from different viewpoints.

Seventeen patients with 24 involved hands were willing to come back for evaluation. The mean age at operation was 12 months. In 8 hands there was also a radial club hand. Buck Gramcko's technique was used with slight modifications. The mean follow-up time was 53 months (ranging from 6 to 142). The outcome was determined in a variety of ways: the functional assessment, cosmesis (objectivated with measurement of thumb length, girth and nail size) and a subjective evaluation of function and aspect done with a patient/parent questionnaire and a visual analogue score.

The mean functional score was: one excellent, eleven good, five fair and five poor results. The mean length was 96% the width was 93%, the nail width was 85%. There was no significant different outcome in the syndrome related thumbs versus the isolated cases, unilateral versus bilateral cases. A significant worse outcome was seen for function and subjective evaluation in the radial club hand associated thumbs and for the functional score for the more severe Blauth group.

The general outcome for non radial club hand associated thumb reconstructions was satisfying. There was good correlation between the different scoring systems.