Case Studies – Pollicisation

Pollicization (or pollicisation) is a hand surgery technique in which a thumb is created from an existing finger.  This consists of surgically migrating the index finger to the position of the thumb in patients who are either born without a functional thumb (most common). Also in an adult who has lost thumb due to trauma this technique can be used.

The presence of an opposable thumb is considered important for manipulation of most objects in the physical world. Children born without thumbs often adapt to the condition very well with few limitations therefore the decision to proceed with pollicization lies with the child’s parents with the recommendation of their surgeon. Persons who have grown to adulthood with functional thumbs and then lost a thumb find it highly beneficial to have a thumb reconstruction, not only from a functional but from a mental and emotional standpoint.

1 year male child presented with history of absent thumb and radial deviation of the wrist on the right side and hypoplastic thumb on the left side. This deformity was there since birth.

Radiographs of both side revealed that radius was absent. The child has four fingers and absent thumb.

Thumb is an important part of hand and functions of hand are restricted without the thumb.

In this patient pollicisation surgery was performed 1^st for left hand followed by right hand.

Both the surgeries were performed at interval of  6 months.

Both surgeries were completed before the child attained 18 months of age as at that age the child starts using the thumb and brain recognizes it.