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J Hand Surg Am. 2009 Sep;34(7):1291-7. doi: 10.1016/j.jhsa.2009.04.001. Epub 2009 Jun 18.

Incidence and treatment of complications, suboptimal outcomes, and functional deficiencies after pollicization.

Author information

1
Shriners Hospital for Children and the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. goldfarbc@wustl.edu

Abstract

PURPOSE:

To evaluate the incidence and treatment of complications, suboptimal outcomes, and functional deficiencies after pollicization, and the need for additional surgical procedures.

METHODS:

A total of 73 index finger pollicizations performed by a single surgeon were identified. We retrospectively evaluated all available patient records for perioperative complications, suboptimal outcomes, and functional deficiencies of the pollicized digit.

RESULTS:

There were 8 complications in the perioperative period (including 3 cases of venous congestion, 4 cases of marginal necrosis, and 1 infection), requiring 12 surgical procedures; 1 pollicized digit was removed owing to nonviability. There were 8 suboptimal outcomes, including 7 cases of scar contracture and 1 with redundant skin, requiring 3 surgical procedures. Additional procedures related to functional deficiencies were performed in 26 total patients, 19 for poor opposition and 15 for limited extension.

CONCLUSIONS:

Most perioperative complications and suboptimal outcomes after pollicization are minor when an experienced surgeon is involved. Venous congestion, although uncommon, is a major viability risk and should be treated aggressively. In addition, a substantial number of pollicized digits have functional deficiencies related to anatomical limitations that can be addressed with muscle and tendon transfers.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

PMID:
19540079
DOI:
10.1016/j.jhsa.2009.04.001
[Indexed for MEDLINE]
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