Long-finger pollicization for macrodactyly of the thumb and index finger

Pollicization of the long finger is rarely performed, and previously described for treating traumatic thumb and index finger loss. Because the long finger lacks the independence of motion and muscular attachments of the index finger, pollicization of the long finger requires modifications of the technique. We present the case of a 3-year-old girl with progressive macrodactyly of the thumb and index finger associated with a lipofibromatous hamartoma of the median nerve. The involved digits were severely enlarged, stiff, and nonfunctional. The child was treated with first and second ray resection followed by long-finger pollicization. Surgical pearls and pitfalls are discussed.