Back to 2026 Abstracts
Reoperation Following Pollicization
Jill R Froimson, MD
1,2, Felicity Fishman, MD
1,2; Terry R. Light, MD
3(1)Shriners Hospitals for Children Chicago, Chicago, IL, (2)Loyola University Medical Center, Maywood, IL, (3)Department of Orthopaedics, Loyola University Medical Center, Maywood, IL
Introduction
Pollicization is a surgical procedure performed to address either a congenital or acquired thumb deficiency. It relocates another digit, most commonly the index finger, to a more thumb-like position, out of the plane of the other digits to improve functions such as prehension and pinch. Historically, pollicization was described as a single stage procedure. Given the variability of anatomy and the complexity of the procedure, the quality of the pollicized digit may be improved by secondary surgery. This study aims to better understand the frequency and timing of secondary surgeries following pollicization as well as patient factors that may necessitate further surgical intervention in order to optimize outcomes.
Materials & Methods
The clinical course of patients with a congenital hand difference who underwent pollicization across two institutions between 2007-2024 were retrospectively reviewed. Patient demographics, diagnoses, radiographs, operative and clinical notes were analyzed. Exclusion criteria included pollicization after trauma, incomplete data, and pollicization follow up of less than 6 months. Descriptive statistics were reported for patient and procedure characteristics. Hazard ratios from univariable shared frailty models were estimated for characteristics associated with need for reoperation.
Results
Seventy- four pollicization procedures in 61 patients at two institutions were reviewed. Seventeen of the reconstructed hands (22.9%) underwent at least one additional procedure after pollicization with five (6.75%) undergoing more than one procedure after the index pollicization. Two hands underwent early reoperation to address soft tissue issues (skin necrosis and retained suture) and an additional two reconstructed hands required reoperation for non-absorbable suture removal. A total of eighteen reoperations intended to augment function were undertaken, with the second surgical procedure performed at an average of 24.8 months following index pollicization. The rate of reoperation was similar regardless of age at pollicization, Blauth hypoplasia type or bilateral hand involvement. Patients were significantly more likely to require additional procedures if they underwent a pollicization for a diagnosis other than radial longitudinal deficiency (p<0.01).
Conclusion
Nearly 23 % of hands that underwent pollicization in our series subsequently underwent at least one secondary procedure addressing the reconstructed thumb. The majority of these secondary procedures were performed to augment function of the neothumb and were performed at an average of 2 years following the initial procedure. Pollicizations performed for congenital differences other than radial longitudinal deficiency were more likely to undergo secondary surgical intervention.
Back to 2026 Abstracts
