When the thumb cannot be replanted due to severe damage, either the least damaged finger in multiple finger injuries should be replanted in the place of the thumb or a later pollicization
procedure or toe to thumb transfer to improve function.
When an adult loses a thumb through trauma or disease, experience in the past half-century shows that the operation to restore function is pollicization of the index finger.
It is not proven that these children will later have some degree of psychological impairment, but there is general agreement among hand surgeons that when a thumb is absent, pollicization should be done in the first year of life.
In an infant born without both thumbs, the only practical operation is bilateral pollicization.
The family was offered a left syndactyly release and ablation of the hypoplastic thumb with pollicization
of the index finger.
Principles of pollicization
are used during the one-stage thumb reconstruction.
The case reported herein, of AVM of the thumb, was treated by thumb amputation and subsequent reconstruction with pollicization.
Pollicization of the index finger was selected for thumb reconstruction for three reasons.
Only two good options are available: pollicization and toe-to-thumb transfer.
When the CMC is intact, options include toe-to-thumb transfers and pollicization of either an injured or uninjured digit.
Pollicization returns better discriminative sensation and fine motor control, whereas toe transfer establishes better strength.
Michon J, Merle M, Bouchon Y, Foucher G: Functional comparison between pollicization and toe-to-hand transfer for thumb reconstruction.