title: Refinements in pollicization:  a 30-year experience.
abstract: The thumb is a specialized organ with unique functions that cannot be replicated by any other digit. The most powerful technique for construction or reconstruction of a lost or missing thumb is index finger pollicization. In this article, the authors outline five technical refinements in this procedure that have evolved over the past 30 years in 313 cases. These refinements improve appearance and function, and include (1) modification of the incisions to produce a well-contoured web space, (2) metacarpal head positioning for optimal recreation of the carpal arch, (3) extrinsic tendon repositioning for improved pronation of the new thumb, (4) intrinsic tendon repositioning for maximal strength, and (5) thenar augmentation with an adipofascial flap in select cases for improved appearance.
authors.affiliation: Boston, Mass.; and New York, N.Y. From Children's Hospital, Harvard Medical School, and St. Luke's-Roosevelt Hospital.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Taghinia
authors.forename: J William
authors.initials: JW
authors.lastname: Littler
authors.forename: Joseph
authors.initials: J
authors.lastname: Upton
mesh_terms: D002348:Carpal Bones / Q000601:surgery; D002648:Child; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D050279:Metacarpal Bones / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D013710:Tendons / Q000601:surgery; D013933:Thumb / Q000002:abnormalities* / Q000601:surgery*