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Virginie Mas, Brice Ilharreborde, Cindy Mallet, Keyvan Mazda, Anne-Laure Simon, Pascal Jehanno
PURPOSE: Functional results of index pollicisation are usually assessed by the clinical score of Percival. This score is based on elementary hand movements and does not reflect the function of the neo thumb in daily life activities. The aim of this study was to develop a new video-assisted scoring system based on daily life activities to assess index pollicisation functional outcomes. METHODS: Twenty-two consecutive children, operated between 1998 and 2012, were examined with a mean of 77 months after surgery...
August 2016: Journal of Children's Orthopaedics
R R Dijkman, C A van Nieuwenhoven, S E R Hovius, W Hülsemann
Radial polydactyly or 'thumb duplication' is the most common congenital upper limb anomaly ('CULA') affecting the thumb. The clinical presentation is highly diverse, ranging from an extra thumb floating on a skin bridge to complicated thumb triplications with triphalangeal, deviating, and hypoplastic components. Radial polydactyly can be classified into one of 7 osseous presentations using the Wassel classification, with type IV (45%), type II (20%), and type VII (15%) occurring most frequently. When faced with a radial polydactyly case, hand surgeons specialised in congenital anomalies must weigh the preoperative functional potential and degree of hypoplasia of both thumbs in order to decide whether to resect one thumb and reconstruct the other ('resection and reconstruction'), excise a central part of both thumbs and unite the lateral tissues into one thumb ('the Bilhaut procedure'), transfer the better-developed distal tissues of one thumb onto the better-developed proximal tissues of the other ('on-top plasty'), or discard both severely hypoplastic thumbs and pollicise the index finger...
February 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Hafiza Fizzah Riaz, Karmoon Lal, Bashir Ahmad, Muhammad Shuaib, Syeda Farwa Naqvi, Sajid Malik
OBJECTIVES: To report on six independent and isolated cases demonstrating thumb aplasia as an essentially limb-specific phenotype. METHODS: The subjects were ascertained during 2011-2013 from six different geographic regions of Pakistan, and underwent detailed clinical and phenotypic examination. RESULTS: The affected arms of patients had complete absence of first digital rays, medial inclinations of second and fifth fingers, narrowing of palms, missing carpals, and shortening of zeugopod...
May 2014: Pakistan Journal of Medical Sciences Quarterly
Mukund R Thatte, Sushil Nehete, Kirti Garude, Rujuta Mehta
Pollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essence we need to: Shorten the Index, recreate the carpo metacarpal joint from the metacarpo phalangeal (MP) joint, rotate the digit by about 120° for pulp to pulp pinch, palmarly abduct by 40-50° to get a new first web gap, Shorten and readjust the tension of the extensors, re attach the intrinsics to form a thenar eminence capable of positioning the new thumb in various functional positions and finally close the flaps forming a new skin envelope...
May 2013: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Samir M Kumta
The history of thumb reconstruction parallels the history of hand surgery. The attributes that make the thumb unique, and that the reconstructive surgeon must assess and try to restore when reconstructing a thumb, are: Position, stability, strength, length, motion, sensibility and appearance. Deficiency in any of these attributes can reduce the utility of the reconstructed thumb. A detailed assessment of the patient and his requirements needs to be performed before embarking on a thumb reconstruction. Most unsatisfactory results can be attributed to wrong choice of procedure...
May 2013: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
S Raja Sabapathy, Hari Venkatramani, Praveen Bhardwaj
INTRODUCTION: Traumatic loss of thumb at the carpometacarpal (CMC) joint level is very disabling to an individual. Pollicisation is the recommended technique of reconstruction for loss of thumb at this level. On occasions, injury to the rest of the hand or amputation of additional fingers may make pollicisation an impossible option. Microsurgical transfer of second toe is an option in such situations. Although many large series of toe transfers are available in the literature, no series deals exclusively with this subset of patients...
March 2013: Injury
Laurence Ceulemans, Ilse Degreef, Philippe Debeer, Luc De Smet
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...
June 2010: Journal of Hand and Microsurgery
M M Al-Qattan
As a part of the pollicisation procedure, previous authors describe interosseous muscle and/or extensor tendon repositioning. The benefit of these tendon transfers has never been investigated despite the fact that other authors have used different techniques or do not perform some of these transfers routinely. In this paper, 16 children (17 hands) with isolated aplasia/hypoplasia of the thumb underwent the pollicisation procedure without any intrinsic tendon transfers. Surgery was performed at a mean age of 22 months and the mean follow-up time was 5 years...
March 2012: Journal of Hand Surgery, European Volume
Michael Tonkin
This review article introduces a new classification of congenital hand anomalies. It then considers the classification of congenital thumb hypoplasia and describes the the authors indications for surgery. Specifically, attention is directed towards surgical techniques and problems encountered in the reconstruction of grade 2 hypoplastic thumbs and in pollicisation of the index finger for grades 3, 4 and 5 thumb hypoplasia.
May 2011: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
A Afshar
In this case report a four-year-old girl with ulnar dimelia is described. She had six digits without mirror symmetry in her right hand. The first pre-axial digit was excised and true pollicisation performed for the second pre-axial digit. The arterial anatomy was abnormal but there was not symmetrical development of the arterial tree.
February 2010: Journal of Bone and Joint Surgery. British Volume
Hironori Matsuzaki, Satoshi Toishi, Takae Yoshizu
We reconstructed the Blauth-IIIB hypoplastic right thumb of a 16-year-old girl with a vascularised metatarso-phalangeal (MTP) joint from her second toe combined with a dorsalis-pedis flap. Abduction was provided with an abductor policis long tendon advancement, and adduction, with an extensor indicis proprius tendon transfer. Opponoplasty was performed one year later using the flexor sublimis (IV) tendon. The transferred joint remained functional and non-osteoarthritic 28 years later. Radial and palmar abduction of the reconstructed thumb was 45 degrees and 75 degrees respectively...
2009: Hand Surgery
Laurens Ceulemans, Ilse Degreef, Philippe Debeer, Luc De Smet
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. Seventeen patients with 24 involved hands agreed 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 (range, 6-142 months)...
April 2009: Acta Orthopaedica Belgica
No abstract text is available yet for this article.
April 1948: British Journal of Plastic Surgery
No abstract text is available yet for this article.
April 1948: British Journal of Plastic Surgery
S Guéro
Thumb hypoplasia is a sequence of congenital abnormalities, from minor hypoplastic thumb with a preserved function to complete thumb aplasia. We only discuss in this chapter on the management of the thumb hypoplasia type 1 to 3A according to the modified Blauth's classification. Their common feature is the conservative treatment, in opposition with severe hypoplastic thumbs usually treated by index pollicisation. Whatever is the degree of hypoplasia, patients should be carefully examined for bilaterality, other anomalies and syndrome...
December 2008: Chirurgie de la Main
R R Clark, S B Watson
We present our experience of two cases in which we carried out pollicisation of the index metacarpal based on the first dorsal metacarpal artery and venae comitans. Both cases were complex severe hand injuries where the initial injury was the result of a firework exploding while held in the hand. In both cases the radial side of the superficial palmar arch was destroyed by the injury. In both cases there was virtually complete loss of the thumb ray and amputation of the index through the base of the proximal phalanx...
2006: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
G Dautel
All the components of the thumb can be involved in congenital hypoplasia. Blauth's classification continues to be helpful for description of the degree of hypoplasia leading to different options of surgical reconstruction. Surgical strategy includes first web deepening, MP ligamentoplasty, thenar augmentation using tendon transfer and correction of associated abnormalities involving the extensor and flexor tendons. For grade IIIB and grade IV, recommended option for reconstruction is index finger pollicisation...
February 2006: Chirurgie de la Main
G Foucher, P Loréa, G Pivato, J Medina, Z Szabo
In certain rare cases of thumb aplasia or hypoplasia, pollicisation of the second finger is not recommended or impossible. It happens when the most radial fingers are hypoplastic or abnormal or when an ulnar prehension pattern has already developed. In these cases, if functional, pollicisation of the most ulnar finger in not suitable because of the ugly cosmetic result. In order to combine the functional advantages of the ulnar pollicisation with a satisfactory cosmetic appearance, the authors describe pseudo-ulnar pollicisation by supination osteotomy...
December 2004: Chirurgie de la Main
No abstract text is available yet for this article.
October 1950: British Journal of Plastic Surgery
S Raja Sabapathy, Sandeep J Sebastin, H Venkatramani, G Balaji
Seven cases of primary reconstruction of traumatic amputation of the thumb using the index finger are reported. In six cases, the reconstruction was done using an injured index finger, while in one case where the amputation of the thumb was through the carpometacarpal joint, an intact index finger was primarily pollicised. This reduces cost of treatment, hospitalisation period and allows earlier rehabilitation without a period of a 'no thumb experience'. We have followed all the patients for a minimum period of 2 years and all of them have excellent functional results...
January 2004: British Journal of Plastic Surgery
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