title: Pollicization of the index finger for traumatic thumb amputation.
abstract: BACKGROUND
  Indications for pollicization of the index finger have decreased since the toe-to-thumb transfer and wraparound flap have been developed for thumb reconstruction. Pollicization, however, remains a useful method of thumb reconstruction depending on the amputation level, age, and patients' requests. The purpose of this study was to evaluate the authors' results and to clarify indications for pollicization.
  
  
  METHODS
  Eight patients treated by pollicization of the index finger after thumb amputation were reviewed retrospectively. Five men and three women were included. The age at surgery ranged from 24 to 66 years, with a mean age of 43 years. Amputation levels included the metacarpophalangeal joint in four patients, the first metacarpal in three, and the carpometacarpal joint in one. The period between injury and pollicization ranged from 0 days to 4 years. Postoperative evaluations included thumb range of motion, opposition and pinch function, grasp and pinch strength, sensation, conversion of position sense, a "picking-up" test, and appearance.
  
  
  RESULTS
  The follow-up period ranged from 5 to 28 years, with an average of 15 years, excluding one patient who died during the follow-up period. The thenar muscles were retained in four patients, who had excellent postoperative function and satisfactory results.
  
  
  CONCLUSIONS
  Pollicization gives excellent results if the thenar muscles can be retained; opposition can be expected after this procedure. However, if the thenar muscles cannot be preserved, the reconstructed thumb may function as a post against the fingers to regain grasping and pinching functions.
authors.affiliation: Department of Orthopedic Surgery, Hiroshima University Faculty of Medicine, Hiroshima, Japan. ishida@hiroshima-u.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishida
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Sunagawa
authors.forename: Osami
authors.initials: O
authors.lastname: Suzuki
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D005385:Fingers / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013933:Thumb / Q000293:injuries* / Q000503:physiopathology