| Pollicization in Adolescence with Skin Island Flap from Floating Thumb and Primary Flexor Tendon Shortening: A Case Report |
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Sam-Kook Park, Joo-Sung Kim, Sang-Hyun Woo |
| 청소년기 부유 무지에서 일차적 굴곡건 단축과 무지 피판을 이용한 무지 형성술: 1 예 보고 |
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박삼국, 김주성, 우상현 |
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| Abstract |
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We report a pollicization technique with primary flexor tendon shortening and first web reconstruction incorporating the skin of the hypoplastic thumb as an island flap. A 14-year-old male with a Blauth’s type IV thumb aplasia on the right had a pollicization of the index finger. The left thumb was also Blauth’ type II. For the skin incision, we followed Scheker’s modification of the Buck-Gramcko method. In addition, an island skin flap was raised from the floating thumb to reconstruct the first web space. After metacarpal shortening, the metacarpal neck was fixed to the base with K-wires. The flexor digitorum profundus tendon of the index finger was shortened equal to the length of the metacarpal shaft excised, and primarily repaired at zone 3. Total active range of motion was 110 degrees, which was 129% of that of opposite side. Functional capacity at 18 months after pollicization was assessed following Menske’s method. Pinching was stronger (7lbs) than the opposite thumb (5 lbs). Grip strength (37 lbs) was similar with opposite hand. Opposition was possible with the 4th finger tip. Subjective satisfaction with function and appearance was high with 85points and 80points, respectively, as rated by the patient and 85points and 90points, respectively, as rated by the parents. |
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