Pollicization of Long Finger After Traumatic Amputation of Thumb and Index Finger

Abstract

We present a 51-year-old male who sustained a traumatic amputation with a saw of the right thumb, index finger, and carpal bones back to the radius. The amputated digits were mangled and not suitable for replantation. We performed pollicization of the long finger which helped restore a more functional hand. In select situations, this reconstructive option has the advantages of being a single-stage procedure with limited donor site morbidity and no need for microsurgical anastomosis.

Keywords: digital amputation; pollicization; traumatic amputation.

Figure 1. Patient injury at presentation and post-pollicization

(A) Amputated thumb and index fingers intraoperatively prior to transposition of middle finger. (B) Result of pollicization of the middle finger.

Figure 2. Radiograph images of patient's injury before and after pollicization

(A) AP: Injury at presentation. (B) Oblique: Injury at presentation. (C) AP: After pollicization. (D) Oblique: After politicization. (E) AP: six-month follow-up. (F) Oblique: six-month follow-up. AP: anterior-posterior.

Figure 3. Six-month follow-up gross motor functions

(A) Pen hold. (B) Key pinch. (C) Gross grasp. (D)  Firm pinch. (E) Gross hold. (F) Firm hold.

Figure 4. Level of thumb injuries and corresponding surgical option(s)

Figure illustrated by author Barkat Ali, MD, University of New Mexico Health Sciences Center.