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

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.