Pollicization in Congenital Differences

Zusammenfassung

Die Pollizisation des Zeigefingers ist eine allgemein anerkannte Operationsmethode bei manchen Fällen von Daumenhypoplasie. Wir überprüften unsere Erfahrungen mit 27 „normalen“ Zeigefingerpollizisationen (mittlere Nachuntersuchungszeit sieben Jahre), wobei Fälle mit höhergradiger Radiushypoplasie und abnormen Fingern ausgeschlossen wurden.

Selbst in einer solch „idealen“ Situation waren sowohl die Kraft als auch die häufig schlanke Erscheinung des neuen Daumens mit ausgedehnten dorsalen Narben und „Spaltbildung“ der ersten Zwischenfingerfalte enttäuschend.

In einer prospektiven Serie von 32 Fällen versuchten wir sowohl die Funktion als auch die Erscheinung des Daumens durch Modifikation der klassischen Schnittführung und der Transposition der Muskeln und Sehnen zu verbessern.

Abstract

Pollicization of the index finger is a well established procedure for some cases of thumb hypoplasia. We reviewed our experience of 27 “normal” index-finger pollicizations with a mean follow-up of seven years, excluding those cases with more extensive radial hypoplasia and abnormal fingers. Even in such an “ideal” situation, strength was deceptive and the frequently slender aspect of the new thumb with quite extensive dorsal scar formation and the “cleft” appearance of the first web disappointing. In a prospective series of 32 cases, we tried to improve both the function and appearance of the thumb by modifying the classical incision as well as the transferred muscles and tendons.

Schlüsselwörter

Pollizisationstechnik - modifizierte Inzision

Key words

Pollicization technique - modified incision

References

• 1 Bartlett G R, Coombs C J, Johnstone B R. Primary shortening of the pollicized long flexor tendon in congenital pollicization.  J Hand Surg [Am]. 2001;  26 595-598
• 2 Barton N J, Buck-Gramcko D, Evans D M, Kleinert H, Semple C, Ulson H. Mirror hand treated by true pollicization.  J Hand Surg [Br]. 1986;  11 320-336
• 3 Blauth W. Prinzipien der Pollizisation unter besonderer Berücksichtigung einer neuen Schnittführung (Principles of pollicisation with special emphasis on new incision methods).  Handchirurgie. 1970;  2 117-121
• 4 Brooks D. Reconstruction of the injured hand. Wynn Parry CB Rehabilitation of the Hand. 2nd ed. London; Butterworths 1966: 341
• 5 Buck-Gramcko D. Pollicization of the index finger. Method and results in aplasia and hypoplasia of the thumb.  J Bone Joint Surg [Am]. 1971;  53 1605-1617
• 6 Buck-Gramcko D. Syndactyly between the thumb and index finger. Buck-Gramcko D Congenital Malformations of the Hand and Forearm. London; Churchill Livingstone 1998: 141-147
• 7 Buck-Gramcko D. Triphalangeal thumb in hand anomalies. Buck-Gramcko D Congenital Malformations of the Hand and Forearm. London; Churchill Livingstone 1998: 403-424
• 8 Clark D I, Chell J, Davis T R. Pollicisation of the index finger. A 27-year follow-up study.  J Bone Joint Surg [Br]. 1988;  80 631-635
• 9 Egloff D V, Verdan C. Pollicization of the index finger for reconstruction of the congenitally hypoplastic or absent thumb.  J Hand Surg [Am]. 1983;  8 839-848
• 10 Foucher G, Navarro R, Medina J, Allieu Y. Pollicization, remains of the past or current operation.  Bull Acad Natl Med. 2000;  184 1241-1253
• 11 Foucher G, Medina J, Navarro R. Pollicization of damaged fingers.  Techniques in Hand & Upper Extremity Surgery. 2000;  4 244-250
• 12 Foucher G, Pajardi G, Lamas C, Medina J, Navarro R. L'allongement par distraction progressive du squelette de la main dans les malformations congénitales. A propos de 41 observations.  Rev Chir Orthop. 2001;  87 451-458
• 13 Foucher G, Medina J, Navarro R. Thumb hypoplasia. Hovius S The Pediatric Upper Limb. London; Martin Dunitz 2002: 133-152
• 14 Foucher G. Vascularized joint transfers. Green D Operative Hand Surgery. 2nd ed. New York; Churchill Livingstone 1988: 1271-1293
• 15 Foucher G. Le transfert d'orteil dans les malformations congénitales.  Bull Acad Nationale Med. 1997;  181 1737-1745
• 16 Foucher G, Gazarian A, Pajardi G. La chirurgie reconstructive dans les hypoplasies type III de Blauth.  Ann Chir Main. 1999;  1 191-196
• 17 Foucher G, Medina J, Navarro R, Nagel D. Toe transfer in congenital hand malformations.  J Reconstr Micro. 2001;  17 1-7
• 18 Foucher G, Medina J, Navarro R. Microsurgical reconstruction of the hypoplastic thumb type IIIB.  J Reconstr Surg. 2001;  17 9-15
• 19 Foucher G, Pivato G, Medina J, Lorea P, Szabo Z. La technique de «pseudo-pollicisation» ulnaire dans les différences congénitales. 2004 in press
• 20 Harrison S H. Pollicisation in children.  Hand. 1971;  3 204-210
• 21 Hentz V R, Littler J W. Abduction-pronation and recession of second (index) metacarpal in thumb agenesis.  J Hand Surg. 1977;  2 113-116
• 22 Ipsen T, Barfred T. Ulnar thumb in cleft-hand-type congenital deformity: case report.  Scand J Plast Reconstr Surg. 1988;  22 257-259
• 23 Kessler I, Baruch A D, Hecht O A. Experience with distraction lengthening of digital rays in congenital anomalies.  J Hand Surg. 1977;  2 394-401
• 24 Kozin S H, Weiss A A, Webber J B, Betz R R, Clancy M, Steel H H. Index finger pollicization for congenital aplasia or hypoplasia of the thumb.  J Hand Surg [Am]. 1992;  17 880-884
• 25 Lister G. Reconstruction of the hypoplastic thumb.  Clin Orthop Rel Res. 1985;  195 52-65
• 26 Littler J W. The neurovascular pedicle method of digital transposition for reconstruction of the thumb.  Plast Reconstr Surg. 1952;  12 303-319
• 27 Littler J W. Principles of reconstructive surgery of the hand. Converse JM Reconstructive Plastic Surgery. Philadelphia; Saunders Company 1964: 1620-1624
• 28 Littler J W. On making a thumb: One hundred years of surgical effort.  J Hand Surg. 1976;  1 35-51
• 29 Malek R, Grossman J AI. The skin incision in pollicization.  J Hand Surg [Am]. 1984;  9 305-306
• 30 Manske P R, McCaroll H R. Index finger pollicization for a congenitally absent or nonfunctioning thumb.  J Hand Surg [Am]. 1985;  10 606-613
• 31 Manske P R, Rotman M B, Dailey L A. Long-term functional results after pollicization for the congenitally deficient thumb.  J Hand Surg [Am]. 1992;  17 1064-1072
• 32 Manske P R, McCaroll H R. Type IIIA hypoplastic thumb.  J Hand Surg [Am]. 1995;  20 246-253
• 33 Müller W. Die angeborenen Fehlbildungen der menschlichen Hand. Leipzig; Thieme 1937
• 34 Nishijima N, Matsumoto T, Yamamuro T. Two-stage reconstruction for the hypoplastic thumb.  J Hand Surg [Am]. 1995;  20 415-419
• 35 Ogino T, Ishii S. Long-term results after pollicization for congenital hand deformities.  Hand Surg. 1997;  2 79-85
• 36 Riordan D C. Congenital absence of the radius.  J Bone Joint Surg [Am]. 1955;  37 1129-1137
• 37 Roper B A, Turnbull T J. Functional assessment after pollicisation.  J Hand Surg [Br]. 1986;  11 399-403
• 38 Segalman K A, McClinton M A, Anthony M S. Reconstruction of an ulnar-sided thumb in central deficiency: a case report.  J Hand Surg [Am]. 2001;  26 40-43
• 39 Shibata M, Yoshizu T, Seki T, Goto M, Saito H, Tajima T. Reconstruction of a congenital hypoplastic thumb with use of a free vascularized metatarsophalangeal joint.  J Bone Joint Surg [Am]. 1998;  80 1469-1476
• 40 Strickland J W, Kleinman W B. Thumb reconstruction. Green DP Operative Hand Surgery. 3rd ed. New York; Churchill Livingstone 1993: 2043-2156
• 41 Sykes P J, Chandraprakasam T, Percival N J. Pollicisation of the index finger in congenital anomalies. A retrospective analysis.  J Hand Surg [Br]. 1991;  16 144-147
• 42 Tajima T. Classification of thumb hypoplasia.  Hand Clinics. 1985;  1 577-594
• 43 Tajima T. Reconstruction of the floating thumb. Buck-Gramcko D Congenital Malformations of the Hand and Forearm. London; Churchill Livingstone 1998: 369-373
• 44 Wood V E. Small finger pollicization in the radial club hand.  J Hand Surg [Am]. 1988;  13 96-99
• 45 Yamauchi Y, Fujimaki A, Yanagihara Y, Yoshizaki K. Reconstruction of floating thumb. Especially on the use of metatarsophalangeal joint grafting.  Seikeigeka Orthopaedic Surgery. 1979;  30 1645-1648
• 46 Zancolli E. Transplantation of the index finger in congenital absence of the thumb.  J Bone Joint Surg [Am]. 1960;  42 658-660