O1305 POLLICISATION BY GRADUAL DISTRACTION

Abstract

Aims: To describe a new & safe technique of gradual distraction for pollicisation of index finger, to which the blood supply is doubtful. This procedure was used in cases where conventional methods of pollicisation are not possible or are risky. Methods: This technique has been utilised in 5 cases (2 traumatic loss of thumb at carpo-metacarpal joint, and 3 cases of absence of thumb associated with radial club hand). The age group was 3–18 years. The procedure consisted of first stage, a webplasty between second & third fingers, osteotomy of the base of second metacarpal and gradual wide abduction of the index finger by distraction. In second stage, the second metacarpal is recessed and rotated, to the position of thumb. At third stage, tendon transfer may be needed for securing the forceful opposition. Results: In all operated 5 cases, desired position of the thumb was obtained along with good function. Conclusion: Gradual distraction for pollicisation may be used in cases where the blood supply of index finger is not based on known specific blood vessel but depends on collateral blood supply. Conventional methods cannot be used or are risky. This technique provides a safe and economical alternative for reconstruction of the thumb, which is a new addition to the armamentarium in thumb reconstruction.