Bilateral Pollicization with Amputated Index Fingers for Thumb Reconstruction in a Case with Multiple Digit Amputations

Abstract

Pollicization surgery for thumb reconstruction has a long-standing history. However, advancements in microsurgery and the widespread use of free tissue transplants from the toe for the surgical treatment of traumatic thumb defects have narrowed the indications of pollicization in thumb reconstruction. Despite this, pollicization offers certain advantages over free flap transfer in specific cases. Literature on cases requiring multiple-digit amputations or bilateral thumb reconstruction is sparse, and the indications for pollicization remain controversial. Here, we present a case of a 31-year-old man who lost multiple fingers, including both thumbs, in an industrial accident. He underwent pollicization surgeries on both hands. At 3 years and 9 months post-surgery, his postoperative course and hand function were assessed as good. In an era where microsurgery is prevalent, pollicization remains a viable option for patients with multiple-digit amputations, including index finger and bilateral thumb loss, provided the functional thenar muscles remain intact.