title: Morphology and Mobility of the Reconstructed Basilar Joint of the Pollicized Index Finger.
abstract: OBJECTIVE
  To evaluate outcome and function of the reconstructed basilar thumb joint after index finger pollicization in patients presenting congenital thumb deficiency.
  
  
  METHODS
  Plain radiographs and 4-dimensional dynamic volume computed tomography scan were used to evaluate the outcome of 23 pollicizations performed on 14 children between 1996 and 2009. The mean follow-up was 8 years. Patients performed continuous movements of thumb opposition during the imaging studies. Four-dimensional scan images made it possible to visualize mobility within the reconstructed joint.
  
  
  RESULTS
  In 14 cases, union occurred in the metacarpal head/metacarpal base interface. In the 9 other cases, there was a nonunion at this interface. The reconstructed joint was mobile in 20 cases, including 3 in which there was also mobility at the site of the nonunion. In 3 cases in our series, mobility was present only at the site of the nonunion, between the base and the head of the second metacarpal. Remodeling and flattening out of the metacarpal head occurred in 16 of 23 cases. The transposed metacarpal head remained spherical in 7 cases.
  
  
  CONCLUSIONS
  The reconstructed joint adapts, both morphologically and functionally, allowing movement on all 3 spatial planes. Existing mechanical constraints on the reconstructed joint may explain its remodeled appearance.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Centre Chirurgical Emile Gallé, University Hospital, Nancy, France. Electronic address: clostrug@gmail.com.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Strugarek-Lecoanet
authors.affiliation: Centre Chirurgical Emile Gallé, University Hospital, Nancy, France.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Chevrollier
authors.affiliation: Centre Chirurgical Emile Gallé, University Hospital, Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pauchard
authors.affiliation: Service d'imagerie Guilloz, University Hospital, Nancy, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Blum
authors.affiliation: Centre Chirurgical Emile Gallé, University Hospital, Nancy, France.
authors.forename: François
authors.initials: F
authors.lastname: Dap
authors.affiliation: Centre Chirurgical Emile Gallé, University Hospital, Nancy, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dautel
mesh_terms: D052737:Carpometacarpal Joints / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery / Q000637:transplantation; D056973:Four-Dimensional Computed Tomography; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008662:Metacarpophalangeal Joint / Q000601:surgery; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013933:Thumb / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: 4D-CT scan; Pollicization; joint remodeling; new trapezium; thumb hypoplasia