Functional Results of Pollicization For Grade IV or V Hypoplastic Thumb - Isolated hypoplastic thumb vs Hypoplastic thumb associated with symphalangism and/or congenital radial clubhand -

Journal of the Korean Society for Surgery of the Hand 2005;10(3):102-108.
Published online September 1, 2005.

Sang Ki Lee, Moon Sang Chung, Young Ho Lee, Hyun Sik Gong, Jae Kwang Kim, Jin Young Kim, Suk Won Jung, Goo Hyun Baek

제 4형 및 5형 무지 저형성증의 무지화 수술 - 선천성 요측 곤봉수나 지유합증이 동반된 경우와 단독으로 발생한 경우의 결과 비교 -

이상기, 정문상, 이영호, 공현식, 김재광, 김진영, 정석원, 백구현

Abstract

Purpose
Congenital hypoplasia of the thumb is often associated with symphalangism and congenital radial clubhand. We compared the results of pollicization for Blauth type 4 with 5 thumb hypoplasia who had associated symphalangism and/or radial clubhand, with those who had thumb hypoplasia alone. Materials and Methods: Sixteen thumbs in 14 patients with type 4 or 5 thumb hypoplasia were operated by pollicization using Buck-Gramcko technique from November 1988 to June 2004. Depending on the existence of associated anomalies with the morbid hand, we classified all cases into 4 groups, the group I is thumb hypoplasia alone (7 cases), the group II is associated with radial club hand (4 cases), the group III is associated with symphalangism (2 cases), and the group IV is associated with both radial clubhand and symphalangism (3 cases). Based on Percival's functional assessment method, the results of operation for both hands in each group were assessed by the strength and accuracy of fingertip and pulp, opposition, grasp, sensibility, and satisfaction at appearance respectively. Results: In terms of postoperative results according to Percival's functional assessment method, a group of thumb hypoplasia alone without associated anomalies accompanied in morbid hands showed the best results, 4 excellent, 2 good, and 1 fair. On the other hand, the group with only radial clubhand associated, showed 1 good, 2 fair and 1 poor. The group with symphalangism associated, showed 2 fair. The group with both radial club hand and symphalangism associated, showed 1 fair and 2 poor. Conclusion: Functional results after pollicization were better in patients with hypoplastic thumb only, than those who had associated symphalangism and/or radial clubhand. Pollicised index finger were functioning as a thumb even in the patients who had associated symphalangism and/or radial clubhand.