Long-term functional results after pollicization for the congenitally deficient thumb.

This study objectively investigated the functional results of 28 index finger pollicizations for correction of congenital deficiency of the thumb. The results indicate that the average total active range of motion at the pollicized digit was 98 degrees, or approximately 50% that of a normal thumb. The average grip strength was 21% of standard values; lateral, tripod, and tip pinch strength values ranged from 22% to 26% of standard values. The pollicized digit was used in the manner of a normal thumb or in modified fashion in 84% of 14 defined activities, with increased use for handling large objects (92%) and less use for small objects (77%). The time required to perform activities averaged 22% longer than the standard for a normal hand. Patients with a radial club hand, a five-finger hand, or a mirror hand on the affected extremity had significantly poorer results; however, patients without one of these associated conditions had near normal use of the pollicized digit, except for reduced strength. These results were not influenced by the age of the patient at the time of operation. This information should be helpful in counseling parents with children who are candidates for pollicization as to what functional results they might anticipate.