Pollicization as a method of the hand bilateral grip restoration for congenital and acquired pathology of the upper limb
Purpose. To analyze the used variants and evaluate the results of restoring the hand bilateral grip in patients with congenital and acquired pathology of the first ray combined with congenital and acquired pathology of the upper limb using the International Classification of Functioning (ICF) before and after surgical treatment. Material and Methods. 94 pollicization surgeries performed in 81 patients at the age from 6 months to 38 years within the period of 2000-2013. Pollicization in its classical form performed in 32 cases for 29 patients. In all other observations the modifications of pollicization surgery used the features of which were caused by a variant of the main pathology or accompanying one. ICF used for function evaluation before and after treatment. Results. Four main groups of pollicization non-standard variants allocated. A positive result achieved in 98.5 % - the improvement of the hand function, structure, use. The best postoperative results obtained in patients with a triphalangeal thumb (TPT). Conclusion. 93.7% of patients had severe and absolute disorders of the hand function and structure before pollicization performance. After pollicization surgery performance the bilateral grip was formed in all the cases except one (1.5 %) being characterized by moderate and light difficulties in the hand use. The best postoperative results achieved in patients with TPT. Light difficulties observed in patients with thumb aplasia and hypoplasia. Moderate disorders remained in case of thumb aplasia and hypoplasia combining with the pathology at forearm level (radial club hand).