Abstract
BACKGROUND: Pollicisation of the index finger for absence or severe hypoplasia of the thumb has been reported as a good procedure to recreate a new 'thumb' with good cosmesis and acceptable function. The purpose of this study is to evaluate the outcome of our series from different viewpoints. METHODS: Seventeen patients with 24 involved hands were willing to come back for evaluation. The mean age at operation was 12 months. In 8 hands there was also a radial club hand. Buck Gramcko's technique was used with slight modifications. The mean follow-up time was 53 months (ranging from 6 to 142). The outcome was determined in a variety of ways: the functional assessment, cosmesis (objectivated with measurement of thumb length, girth and nail size) and a subjective evaluation of function and aspect done with a patient/parent questionnaire and a visual analogue score. RESULTS: The mean functional score was: one excellent, eleven good, five fair and five poor results. The mean length was 96% the width was 93%, the nail width was 85%. There was no significant different outcome in the syndrome related thumbs versus the isolated cases, unilateral versus bilateral cases. A significant worse outcome was seen for function and subjective evaluation in the radial club hand associated thumbs and for the functional score for the more severe Blauth group. CONCLUSION: The general outcome for non radial club hand associated thumb reconstructions was satisfying. There was good correlation between the different scoring systems.