Index Pollicization Research Articles

Primitive neuroectodermal tumor of the thumb metacarpal bone: A case report and literature review

A 27-year-old otherwise healthy patient was diagnosed with a primitive neuroectodermal tumor of the thumb metacarpal bone of the left hand. Based on a common chromosomal translocation this tumor shows a close relationship to Ewing's sarcoma. Its occurrence in the extremities is uncommon and involvement of the hand is extremely rare. The treatment consisted of neo- and adjuvant chemotherapy and marginal resection of the affected thumb metacarpal bone including periosseous soft tissue and reconstruction of the thumb by an intercalated segmental index pollicization. (J Hand Surg 2003;28A:346-352. Copyright © 2003 by the American Society for Surgery of the Hand.)

Type III—A hypoplastic thumb

Thirteen type III-A hypoplastic thumbs were reviewed. The abnormalities included those found in type II hypoplasia (narrow thumb-index web space, hypoplastic thenar muscles, unstable metacarpophalangeal joint, as well as extrinsic tendon abnormalities); all had stable carpometacarpal joints. They are differentiated from type III-B hypoplastic thumbs, which have an unstable carpometacarpal joint due to a deficient base of the metacarpal. The extrinsic tendon abnormalities included absent extensor pollicis longus tendon, absent or aberrant flexor pollicis longus tendon, and a tendon interconnection between the flexor pollicis longus and extensor aponeurosis. Twelve of the thumbs had surgical reconstruction. None was treated with ablation and index pollicization.

Index Pollicization in Congenital Deformity. A Long-Term Follow Up of 62 Cases

Index Pollicization in Congenital Deformity. A Long-Term Follow Up of 62 Cases

The skin incision in pollicization

A variety of skin incisions have been proposed for index pollicization. Ideally, this incision should satisfy several basic requirements. It should provide viable skin flaps and good exposure of the underlying structures. The skin closure should create a natural and supple first web space. The scars should be designed to be as inconspicuous and aesthetically pleasing as possible with little risk of later contracture. Finally, the planning should be clear, simple, and easily understood by the hand surgery trainee. We present an incision that meets these requirements, and it has been used in over 100 cases of index pollicization during the last 15 years.