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

Hand injuries from firecrackers require precise repair, especially when the thumb is involved due to its crucial role in grasping, pinching, and daily activities. In this study, we evaluate the outcomes of selective soft tissue pollicization in a patient who sustained fireworks injuries, including multiple wounds, amputations with bone exposure, digital nerve transections, and extensive soft tissue damage across several fingers. Numerous methods exist to achieve optimal results, each with benefits and downsides. Through comprehensive assessment and meticulous surgical technique, we present the therapeutic management of a case that necessitated a selective approach to reconstruction, with focusing on preserving neurovascular bundles and tendons. Post-surgery, the patient regained full sensation and functional movement in the first metacarpophalangeal and interphalangeal joints, closely mirroring a normal thumb, enabling effective grasping, pinching, and opposition movements for daily tasks.