Index finger pollicization for a congenitally absent or nonfunctioning thumb.

Forty pollicizations of index fingers were done to correct congenitally absent or nonfunctioning thumbs in patients who were younger than 16 years old. Twenty-six additional operations were performed after pollicization on 20 transposed digits, including opposition transfer (18), extensor tendon shortening (four), and arthrodesis (four). The operations improved not only the cosmetic appearance of the hand, but the functional ability of the patients to grasp and handle large objects; preoperative ability to pinch and handle small objects was not impaired by the operative procedure. The additional operative procedures were required most often in patients with radial club hands and/or previous centralization.