absent thumb ( thumb hypoplasia )
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.
Blauth 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.
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.)
Usually surgery is performed at 1–2 years when thumb function is developing.
Usually, only one surgery (pollicisation) is required; however few touch up procedures can be required later on.
Few minutes to hours, it depends on thumb deformaty.
In patient is required for the procedure and usually patient admits for one to two days.
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