Pollicization a past or current operation

Pollicization is a long time honored operation but more recent introduction of microsurgical techniques allowing toe to thumb transfers has changed th e indications in trauma and congenital malformations. We reviewed two serie s of patients to assess the long-term result in both traumatized and malfor med hands. Twenty-seven pollicized mutilated fingers were reviewed with a m ean follow up of 9.5 years; the longest follow up published in the literatu re. Despite the age quite advanced of the population and multidigital amput ations (mole than two fingers were amputated in 16 cases), 21 patients had a good or fair result on a global score including mobility, sensibility, da ily use, cortical integration, cold intolerance or pain and appearance. In congenital malformations, hypoplasia or aplasia of the thumb in presence of long fingers remains one of the best indication of pollicization. Out of 3 5 operated children, 27 were reviewed with a sufficient follow up (mean 6 y ears) to assess the result. Sensibility and growth were excellent (3 cases need some secondary shortening) mobility was close to normal in 61 % of cas es but the main concern was the strength which reached only 42 % of the sta ndard.