It is a spectrum of congenital deformity of the thumb varying from small defects to complete
absence. It can be isolated, when only the thumb is affected, and in 60% of the cases it is
associated with deficiency of lateral (radial) hand structures.

SYMPTOMS 

DEPEND ON SEVERITY OF DISEASE 
Baluch’s classification
TYPE I –small thumb
TYPE II – small thumb with muscles deficiency
TYPE III – small thumb with muscles and skeletal deficiency
TYPE  IV – Small thumb attached to the hand by a soft tissue bridge (floating thumb or ‘pounce flatten’)
TYPE V – Total absence of the thumb.
Operative Procedure
Type I: good function… does not require surgery.
Type IIIB, IV and V: ablation of any thumb elements and reproduce thumb function by shortening and
rotating the index finger (pollicization) and reconstruction of deficient tendons and ligament (UCL, FPL,
EPL etc.)
FAQS
1. At what age surgery should be performed?
Usually surgery is performed at 1–2 years when thumb function is developing.
2. How many surgeries will be necessary?
Usually, only one surgery (pollicization) is required; however few touch up procedures can be required
later on.
3. What is approximate duration of procedure?
Few minutes to hours, it depends on thumb deformity.
4. What setup is required for procedure?
In patient is required for the procedure and usually patient admits for one to two days.

 

Written by : Dr. Afaq Saleem
Copyrights: Pakistan association of Plastic Surgeons