Outcome after pollicization: comparison of patients with mild and severe longitudinal radial deficiency.

Background: Pollicization of the index finger is a well-established treatment in type IIIB to type V hypoplastic thumbs. However, there is a lack of quantitative outcome studies, and little is known about the outcome differences between patients with mild and severe longitudinal radial deficiencies. Therefore, the aim of this study was to quantitatively assess and compare outcome after pollicization in severe and mild longitudinal radial deficiency and compare outcome to healthy controls.

Methods: In total, the authors included 24 patients with 30 affected hands. The study group consisted of 16 male patients and eight female patients with a mean age of 14 years. Median time between pollicization and evaluation was 9.4 years. Active and passive range of motion, extrinsic and intrinsic strength, sensibility, and patient and parent satisfaction were measured in patients with mild and severe longitudinal radial deficiency. Means are expressed as a percentage of normative data, and standard deviations and ranges were calculated. The independent samples t test was used to compare means between groups.

Results: In the overall pollicization group with associated longitudinal radial deficiency, range of motion and strength were significantly diminished compared with normative data. In severe longitudinal radial deficiency, all strength measurements were significantly more affected than in mild longitudinal radial deficiency.

Conclusions: Overall, range of motion and strength of pollicizations were diminished compared with normative data. In severe longitudinal radial deficiency, this was even more pronounced. Despite this outcome, patients and their parents were very satisfied with function and appearance of the new thumb.