Long-term outcomes after pollicization: a mean 11-year follow-up study

Area of Science:

• Orthopedic surgery
• Pediatric reconstructive surgery

Background:

• Congenital absence or severe hypoplasia of the thumb significantly impacts hand function.
• Pollicization is a reconstructive procedure to address thumb deficiency.

Purpose of the Study:

• To evaluate the long-term clinical and radiological outcomes of pollicization.
• To compare outcomes between simple thumb hypoplasia and radial longitudinal dysplasia.
• To assess patient satisfaction and functional results after pollicization.

Main Methods:

• Retrospective review of 29 patients undergoing 34 pollicizations.
• Classification into simple thumb hypoplasia and radial longitudinal dysplasia groups.
• Clinical and radiological examinations, patient questionnaires, and Percival score assessment.
• Mean follow-up of 11 years (range 1.3–32 years).

Main Results:

• Grip and pinch strength were below normative values in both groups.
• Flattening of the metacarpal head observed in 20/34 operated hands.
• Higher patient satisfaction reported in the simple hypoplasia group compared to radial longitudinal dysplasia.
• No correlation found between functional outcomes/satisfaction and age at operation.

Conclusions:

• Pollicization offers improved patient satisfaction, particularly in simple thumb hypoplasia, despite persistent functional deficits.
• Radiological changes like metacarpal head flattening are common long-term findings.
• Age at operation is not a determining factor for long-term functional outcomes or patient satisfaction.