Indian Journal of Plastic Surgery
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Year : 2013  |  Volume : 46  |  Issue : 2  |  Page : 303--311

Unfavourable results in pollicisation


1 Bombay Hospital and Institute of Medical Sciences, Bai Jerbai Wadia Hospital for Children, Shushrusha Citizens' Co op. Hospital, Mumbai, Maharashtra, India
2 Bombay Hospital and Institute of Medical Sciences, Mumbai, Maharashtra, India
3 Balabhai Nanavat Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Mukund R Thatte
Room 6, 2nd Floor, New Wing, Bombay Hospital, New Marine Lines, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0358.118609

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Pollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essence we need to: Shorten the Index, recreate the carpo metacarpal joint from the metacarpo phalangeal (MP) joint, rotate the digit by about 120° for pulp to pulp pinch, palmarly abduct by 40-50° to get a new first web gap, Shorten and readjust the tension of the extensors, re attach the intrinsics to form a thenar eminence capable of positioning the new thumb in various functional positions and finally close the flaps forming a new skin envelope. The author has performed over 75 pollicisations personally and has personal experience of some of the issues raised there. The steps mentioned therefore are an algorithm for helping the uninitiated into these choppy waters.






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