Pulgarización del índice en amputación traumática de pulgar mediante técnica de Buck-Gramcko modificada. Reporte de caso

Abstract

BackgroundTraumatic amputation of the thumb is an uncommon injury but nevertheless a devastating one, and represents a small percentage of emergency visits. The aim of this study is to present the experience of index finger pollicisation as a complex reconstructive management for a thumb amputation of the dominant hand in a 10-year-old patient, as well performing an analysis of the functional results. Case ReportA 10-year-old patient with traumatic amputation of thumb had a surgical reconstruction of the injury by using an index finger pollicisation technique as described by Buck-Gramcko and modified by the senior author in order to achieve the results required in anatomy, functionality, and aesthetics. Excellent results, measured by Percival Hand functionality thumb Score, were obtained 6 months after the surgery, with a maximum score of 20 points (higher quality). Pincer grip and cylindrical hand grip skills were recovered as well as flexion, extension, adduction, and opposition of the thumb for an overall rate 90% when compared with an uninjured thumb. DiscussionIndex finger pollicisation is important for the management of traumatic thumb amputation due to the excellent results obtained in terms of functionality, aesthetics, and anatomy, and should always be considered as a surgical alternative.Evidence Level: IV