Index Finger Pollicization For Traumatic Thumb Amputation
Pollicization is a hand surgery technique which substitutes a functioning finger for a deficient thumb. The most common indication is thumb hypoplasia with absence or instability of the carpometacarpal joint. However, there are additional causes that may negate thumb function, such as trauma, macrodactyly , multi-fingered hand and a mirror hand.
We present a rare case of 14 year old male with a traumatic loss of left thumb and loss of index finger extensors, 4 years back in a crush injury. Index finger was pollicized & extensor tendons were reconstructed improving the function and aesthetics of the hand.
CASE REPORT :
A 14 years old male presented with traumatic loss of left hand thumb in a crush injury 4 years back while travelling on a bike with his father they met with a road traffic accident which lead to a degloving injury and ultimately lead to the necrosis of the thumb and loss of extensors of the index finger of the left hand . Patient was at that time operated and amuptation of the thumb was done followed by skin grafting over the left hand. Now patient presented with difficulty to grasp/ hold things and performing daily activites with the left hand. This lead to making him slow in doing daily activities as compared to other children of his age group which lead to an inferiority complex in the child and effected him psychologically to. The deformity of his hand made him shy of presenting himself in front of others which lead to making the child an introvert and reduced his communication skills .
On examination, the thumb was absent and there was malunion of index finger metacarpal along with loss of index extensors on dorsum of hand. Rest fingers were functionally normal.
Intra operatively first we carried out the division of intra metatarsal ligaments , after which we transferred the index finger with head of metatarsal and intact neurovascular pedicle, followed by positioning of index finger as thumb with the extensors of the thumb.