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

 Blauth’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 ‘pouce flottant’) 

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 the 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 the approximate duration of the procedure?

Few minutes to hours, it depends on thumb deformity.

4. What setup is required for the procedure?

A patient is required for the procedure and usually the patient admits for one to two days.

 

Written by :  Dr. Afaq Saleem

Copyrights: Pakistan association of Plastic Surgeons