gms | German Medical Science

Objectives/Interrogation: Pollicisation is one of the most anatomical options for repairing the bilateral hand grip. The main idea of this operation is to create the skeletal anatomy and biomechanics of a normal thumb. However, the surgeon is always limited in the number of motor units which he can use to reproduce the entire volume of motions of the normal thumb and classical technique of pollicization does not imply the creation of an active rotation of the new thumb.

Methods: The new technics was used in operative treatment in 34 patients with hypoplasia of the thumb (type IIIB-IV Blauth) aged 0.5-2 years. Cross-transposition of the interosseus muscles of the index was made with fixation to the lateral bands of the extensor tendon. EDC tendon was fixed to the radial surface of the proximal phalanx throw the tunnel. The maximal follow-up period was 3.5 years.

Results and Conclusions: All patients demonstrated active rotation of the new thumb in combination with abduction. In 64,7% of patients rotation consisted 140-165 degrees; in 23,5% - 120-140 degrees and in 11,8% of patients - less the 120 degrees. All patients had full active extension of the thumb in all joints.

Transposition of the interosseous muscles in pollicization helps to improve the possibilities of active and passive rotation of the new thumb without reducing the amplitude of active extension.