Treatment of Nonreplantable Total Thumb Amputation at the CMC Level Using Index Finger Pollicization
Autor: | Andrew Y. Zhang, Sonya P. Agnew, Ryan M. Dickey, Anna Meade |
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Rok vydání: | 2021 |
Předmět: |
Orthodontics
030222 orthopedics Pollicization business.industry Index finger 030230 surgery Thumb Amputation Surgical Fingers body regions 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Amputation Traumatic Activities of Daily Living Thumb amputation Humans Medicine Orthopedics and Sports Medicine Surgery business Thumb reconstruction |
Zdroj: | HAND. 17:1154-1162 |
ISSN: | 1558-9455 1558-9447 |
Popis: | Background Pollicization of the index finger is a rarely performed reconstructive option for patients with total thumb amputations with nonsalvageable carpometacarpal (CMC) joint and thenar muscles. Successful pollicization can provide basic grasp and pinch to help patients carry out activities of daily living. We present a retrospective review of 4 patients who underwent index finger pollicization for traumatic total thumb amputations. Methods A retrospective review of 4 cases of pollicization using an injured index finger for traumatic thumb amputation was performed. Patients available for follow-up were contacted for functional assessment. Outcomes including range of motion (ROM), grip strength, key pinch, 2-point discrimination, and Disabilities of the Arm, Shoulder, and Hand score were obtained. Functional thenar muscle and the CMC joint were absent in all cases. Injury mechanism was firework in 2 patients and crush in 2 patients. Results The time from injury to pollicization ranged from 8 days to 17 months. Follow-up time ranged from 10 weeks to 3 years. Three patients regularly used the pollicized thumb in activities of daily living such as writing. Tip pinch and lateral pinch along with grip strength were weak in all cases; the best recorded pinch strength was 24% and grip strength was 25% compared with the contralateral hand. The ROM of the pollicized thumb was limited. Conclusions Index finger pollicization following total thumb amputation can be a viable last-resort option for patients. The pollicized digit acts as a sensate post and avoids further morbidity from the traumatized extremity. |
Databáze: | OpenAIRE |
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