TY - JOUR
T1 - Incidence and Treatment of Complications, Suboptimal Outcomes, and Functional Deficiencies After Pollicization
AU - Goldfarb, Charles A.
AU - Monroe, Eric
AU - Steffen, Jennifer
AU - Manske, Paul R.
PY - 2009/9
Y1 - 2009/9
N2 - 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.
AB - 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.
KW - Hypoplastic thumb
KW - amputation
KW - complication
KW - pollicization
KW - vascular
UR - http://www.scopus.com/inward/record.url?scp=68849083034&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2009.04.001
DO - 10.1016/j.jhsa.2009.04.001
M3 - Article
C2 - 19540079
AN - SCOPUS:68849083034
VL - 34
SP - 1291
EP - 1297
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
SN - 0363-5023
IS - 7
ER -