ABSTRACT

The congenital deficiencies of the thumb include a spectrum of anomalies such as hypoplasia and aplasia, constriction band syndrome, brachydactyly and true transverse absence. The severity of the deficiency varies and in order to define an outline of treatment a practical classification was suggested by Blauth. The classification serves as a basic guideline for identifying specific problems of management and for planning treatment. The pollicisation is recommended for all type IV and V deficiencies and quite gratifying functional and cosmetic results can be obtained by the intricate operation. There is disagreement regarding the preferred treatment for type III deficiency; most prefer to perform a pollicisation while a few surgeons attempt reconstruction as indicated earlier. pollicisation is a simpler operation and the cosmetic appearance is better than after a microvascular joint transfer. The range of movement of the thumb is also greater following pollicisation.