Incidence and treatment of complications, suboptimal outcomes, and functional deficiencies after pollicization.
OBJECTIVE
To evaluate the incidence and treatment of complications, suboptimal outcomes, and functional deficiencies after pollicization, and the need for additional surgical procedures.


METHODS
A total of 73 index finger pollicizations performed by a single surgeon were identified. We retrospectively evaluated all available patient records for perioperative complications, suboptimal outcomes, and functional deficiencies of the pollicized digit.


RESULTS
There were 8 complications in the perioperative period (including 3 cases of venous congestion, 4 cases of marginal necrosis, and 1 infection), requiring 12 surgical procedures; 1 pollicized digit was removed owing to nonviability. There were 8 suboptimal outcomes, including 7 cases of scar contracture and 1 with redundant skin, requiring 3 surgical procedures. Additional procedures related to functional deficiencies were performed in 26 total patients, 19 for poor opposition and 15 for limited extension.


CONCLUSIONS
Most perioperative complications and suboptimal outcomes after pollicization are minor when an experienced surgeon is involved. Venous congestion, although uncommon, is a major viability risk and should be treated aggressively. In addition, a substantial number of pollicized digits have functional deficiencies related to anatomical limitations that can be addressed with muscle and tendon transfers.


METHODS
Therapeutic IV.
Goldfarb
Charles A
CA
Shriners Hospital for Children and the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. goldfarbc@wustl.edu
Monroe
Eric
E
Steffen
Jennifer
J
Manske
Paul R
PR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005385:Fingers / Q000637:transplantation*; D006801:Humans; D015994:Incidence; D007223:Infant; D007431:Intraoperative Complications; D008662:Metacarpophalangeal Joint / Q000502:physiology; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013933:Thumb / Q000002:abnormalities*; D016896:Treatment Outcome