Do you know what pollicization is?

This Procedure is Part of Shriners Hospital Patient Treatments

On this occasion, we interviewed Dr. Miguel Ángel Hernández Álvarez, an orthopedic doctor with a subspecialty in hand surgery and microsurgery that he performed at the National Rehabilitation Institute and who has been part of Shriners Hospital Staff since 2008.

“I am part of the medical staff, I am dedicated to treating problems related to hand pathologies, such as, for example: congenital problems, nerve injuries, fractures, trauma sequelae, tumor lesions in the childrens’ upper limbs, everything that somehow has to do with pathologies that affect the upper limb function in children.”

Treatments at Shriners Hospital

There are many areas in which the hospital has significantly impacted patient function improvement and quality of life. Pathologies for which treatments at the Hospital become very costly are treated at no cost for the patient and their family. An in-depth study of these pathologies is held, since sometimes it is not only the malformation of the upper limb, but it is also accompanied by other affectations at the level of heart, abdominal organs, etc.; in this way, the mission of the Hospital is to help the patients reach their full potential through the treatments that can be offered here, whether in the field of neuromuscular pathology, malformations, trauma sequelae, nerve injuries, etc.

What is Pollicization?

Pollicization is currently one of the procedures performed quite frequently at Shriners Hospital. This procedure consists in converting one of the fingers of the hand into a thumb for patients who are unfortunately born without this finger, or that have lost their thumb due to some type of trauma. The thumb represents about 50% of the hands’ function.

“We have the possibility of converting the index finger into a thumb, not only to make it function as a thumb, but with the cosmetic advantage of being an unnoticeable operation, so this adds a plus to this type of procedure,” says Dr. Hernandez. Shriners Hospital is among the hospitals with the highest patient volume with this pathology nationwide. Over 15 years, it has treated approximately 350 patients, and performs at least one pollicization per week.

Are there risk factors?

According to a patient study involving active patients with a diagnosis of radial clubhand, “Radial clubhand at Shriners Hospital México and review of the Literature", in which Dr. Hernández participated, out of 71 patients studied, the prevalence was 64.7% in men and 35.3% in women.

There is no risk factor for this pathology, but as these are problems that occur between the forth and sixth week of pregnancy, other organs are also affected in parallel, meaning there can be syndromes associated with this pathology, as indicated by the study in which Dr. Hernandez participated, where it was observed that 42.25% of patients that lack a thumb suffered from some syndrome.

Pollicization and rebirth

The Renaissance physician named Tagliacozzi was the pioneer in this technique. When a thumb was absent, he sutured the affected hand to the foot for a period of approximately 3 months, thus integrating the toe into the circulation of the hand. This is known as osteoplastic reconstruction, and is known as the basis of the thumb technique.

What is the best part of working at Shriners Hospital?

“Without a doubt, it is being able to provide the best quality treatment to patients who, in other circumstances, would be excluded from this care. Unfortunately, as I mentioned before, the treatment for this kind of pathology is costly and involves many people, but fortunately the hospital can provide this care as part of its mission. This gives surgeons an extra reason to be here giving the best we can so that the children of tomorrow have as much potential and capability as they decide,” concludes Dr. Hernández.