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Arch Hand Microsurg > Volume 24(2); 2015 > Article
Archives of Hand and Microsurgery 2015;24(2):62-67.
Published online November 30, 2015.
Pollicization of the Middle Finger
Sujin Bahk, Su Rak Eo*, Sang Hun Cho, and Neil Ford Jones1
1Department of Plastic and Reconstructive Surgery, Dongguk University Graduate School of Medicine, Seoul, Korea.
2University of California Irvine Center for Hand and Upper Extremity Surgery, University of California Irvine, Irvine, CA, USA.
Received: 28 September 2015   • Revised: 12 November 2015   • Accepted: 17 November 2015


Pollicization typically involves surgical migration of the index finger to the position of the thumb. This procedure facilitates the conversion of a useless hand into a well-functioning one in patients who are not amenable to the toe-to-hand transfer. However, middle finger pollicization has been rarely reported.

Materials and Methods:

We reconstructed a thumb by immediate pollicization of the remnants of the middle finger in two patients who sustained a tumor and a trauma, respectively. The former, after cancer ablation was performed, has not been reported literally, and the latter involved free devitalized pollicization of the middle finger using a microsurgical anastomosis. The distal third extensor communis tendon was sutured to the proximal extensor pollicis longus tendon and the distal flexor digitorum superficialis and profundus were sutured to the proximal flexor pollicis longus. The abductor pollicis brevis tendon was sutured to the distal end of the first palmar interosseous muscle. Coaptation of the third digital nerve and the superficial radial nerve branch was performed.


Patients showed uneventful postoperative courses without complication such as infection or finger necrosis. Based on the principles of pollicization, a wide range of pinch and grasp movements was successfully restored. They were pleased with the functional and cosmetic results.


Although the index finger has been the digit of choice for pollicization, we could also use the middle finger on specific occasions. This procedure provides an excellent option for the reconstruction of a mutilated thumb and could be performed advantageously in a single step.

Key Words: Neoplasms, Injuries, Thumb, Fingers

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