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LONG TERM RESULTS OF THE CORRECTION OF THUMB HYPOPLASIA BY POLLICISATION



Abstract

Introduction and Objectives: One of the techniques used to improve function in thumb hypoplasia is Pollicisation, this is used in thumb hypoplasia Blauth grade 3b, 4 and 5. The objectives of this technique are: to modify the position of the index finger, its length and tendon insertions, while maintaining original circulation and sensitivity; so as to achieve a thumb capable of responding to a medium-high functional demand. We assessed the results obtained using the Buck-Gramcko technique in the 12 de Octubre Hospital.

Materials and Methods: We retrospectively analyzed 10 pollicisations performed between 1986–2008, 3 patients had bilateral hypoplasia and another two suffered from polymalformation syndrome. Mean age at surgery was 27 months, and the minimum postoperative follow-up was 10 months. An objective assessment of results was based on: morphology, sensitivity, intrinsic-extrinsic mobility and strength. During analysis of the results we also took into account the subjective assessment of parents and children.

Results: In all cases the sensitivity of the new thumb was satisfactory, extrinsic mobility was good, and intrinsic mobility, although less in the cases of bilateral hypoplasia and polymalformation syndrome, was satisfactory. Subjective assessment showed a high functional integration of the new thumb, and a high degree of satisfaction on the part of parents and children.

Discussion and Conclusions: Pollicisation is an effective technique that improves hand function in patients with thumb hypoplasia as from Blauth stage 3b.

The abstracts were prepared by E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedic Surgery and Traumatology (Revista Española de Cirugía Ortopédica y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología, calle Fernández de los Ríos 108, 28015-Madrid, Spain