The Role of Selective Soft Tissue Pollicization for Thumb and First Web Reconstruction - A Case Report

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Trauma Reconstruction

Background:

• Firecracker injuries frequently cause severe hand trauma, particularly to the thumb, compromising essential functions like grasping and pinching.
• Reconstructing complex hand injuries requires tailored surgical approaches to optimize functional recovery.

Observation:

• A patient presented with extensive fireworks-related injuries, including multiple wounds, amputations with bone exposure, digital nerve transections, and significant soft tissue damage.
• The case involved a complex reconstruction necessitating a selective approach to preserve critical neurovascular structures and tendons.

Findings:

• Selective soft tissue pollicization was employed for therapeutic management of the severe hand injuries.
• Post-operative assessment revealed the patient achieved full sensation and functional movement in the first metacarpophalangeal and interphalangeal joints.
• The reconstructed thumb demonstrated effective grasping, pinching, and opposition, closely resembling normal thumb function for daily tasks.

Implications:

• Selective soft tissue pollicization is a viable and effective reconstructive strategy for severe thumb injuries resulting from firecrackers.
• Meticulous surgical technique focusing on neurovascular and tendon preservation is crucial for successful outcomes in complex hand trauma.
• Restoration of thumb function significantly improves a patient's quality of life by enabling daily activities.