Unfavourable results in pollicisation

Pollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essen...

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Main Authors: Mukund R Thatte, Sushil Nehete, Kirti Garude, Rujuta Mehta
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2013-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=303;epage=311;aulast=Thatte
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author Mukund R Thatte
Sushil Nehete
Kirti Garude
Rujuta Mehta
author_facet Mukund R Thatte
Sushil Nehete
Kirti Garude
Rujuta Mehta
author_sort Mukund R Thatte
collection DOAJ
description Pollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essence we need to: Shorten the Index, recreate the carpo metacarpal joint from the metacarpo phalangeal (MP) joint, rotate the digit by about 120° for pulp to pulp pinch, palmarly abduct by 40-50° to get a new first web gap, Shorten and readjust the tension of the extensors, re attach the intrinsics to form a thenar eminence capable of positioning the new thumb in various functional positions and finally close the flaps forming a new skin envelope. The author has performed over 75 pollicisations personally and has personal experience of some of the issues raised there. The steps mentioned therefore are an algorithm for helping the uninitiated into these choppy waters.
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publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
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series Indian Journal of Plastic Surgery
spelling doaj-art-1b09049d040d47c3a2ca0298e3020ea12025-08-20T01:59:05ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2013-01-0146230331110.4103/0970-0358.118609Unfavourable results in pollicisationMukund R ThatteSushil NeheteKirti GarudeRujuta MehtaPollicisation of the index finger is perhaps one of the most complex and most rewarding operations in hand and plastic surgery. It however has a steep learning curve and demands very high skill levels and experience. There are multiple pitfalls and each can result in an unfavourable result. In essence we need to: Shorten the Index, recreate the carpo metacarpal joint from the metacarpo phalangeal (MP) joint, rotate the digit by about 120° for pulp to pulp pinch, palmarly abduct by 40-50° to get a new first web gap, Shorten and readjust the tension of the extensors, re attach the intrinsics to form a thenar eminence capable of positioning the new thumb in various functional positions and finally close the flaps forming a new skin envelope. The author has performed over 75 pollicisations personally and has personal experience of some of the issues raised there. The steps mentioned therefore are an algorithm for helping the uninitiated into these choppy waters.http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=303;epage=311;aulast=ThatteOperative stepspollicisationunfavourable results
spellingShingle Mukund R Thatte
Sushil Nehete
Kirti Garude
Rujuta Mehta
Unfavourable results in pollicisation
Indian Journal of Plastic Surgery
Operative steps
pollicisation
unfavourable results
title Unfavourable results in pollicisation
title_full Unfavourable results in pollicisation
title_fullStr Unfavourable results in pollicisation
title_full_unstemmed Unfavourable results in pollicisation
title_short Unfavourable results in pollicisation
title_sort unfavourable results in pollicisation
topic Operative steps
pollicisation
unfavourable results
url http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=2;spage=303;epage=311;aulast=Thatte
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AT kirtigarude unfavourableresultsinpollicisation
AT rujutamehta unfavourableresultsinpollicisation