Pollicization

Pollicization is the reconstruction of a new thumb by using one of the digits on the same hand - usually the index finger. It is indicated in a few rare situations:

• acquired total traumatic thumb loss
• congenital:
  • thumb hypoplasia with an absent or very unstable carpometacarpal joint
  • thumb aplasia
  • five or more fingered hand

For the congenital causes, typically pollicization is carried out before the age of two years to permit development of a prehensile grip with the reconstructed digit. After this time, compensatory grips may develop eg side-to-side pinch patterns between the index and middle fingers. Ideally, the index finger that is transferred is not too stiff as this will affect its function in the recipient site.