Pollicization of the index finger in hypoplasia of the thumb. Experience with the method of Buck-Gramcko and retrospective analysis of the clinical outcome in a series of 19 pollicizations

Background In congenital malformation of the thumb index finger pollicization is a proven method for constructing a new thumb all over the world. Methods A series of 19 pollicizations in 15 patients is presented. In all cases of index finger pollicization the method of Buck-Gramcko is used and the functional outcome is evaluated after Percival's method. Three special cases are described in detail and the preoperative evaluation with a CT-angiography in cases of complex malformations (case 3) for better planning of the surgical steps is recommended. The importance of parent's information soon after giving birth to a child with thumb hypoplasia is described in detail as the postoperative management. Results In children with bilateral deformities of the hand the surgery can be performed in one session, in only 2 cases a second operation was necessary. The postoperative results were excellent and good (Percival's measurement) and the children are now able to perfectly use their affected hand in their day-to-day activities. Conclusion Buck-Gramcko's method of pollicization in congenital thumb malformation gives excellent results. The preoperative planning and exactly following the four key steps is as important as the postoperative management.