[Reconstruction of isolated traumatic amputation of the thumb. Role of annular pollicization].

Fifteen pollicisations of undamaged ring fingers were carried out after isolated thumb amputations, occurring most of the time above the MP in manual workers. All these patients were re-examined with a minimum two years' follow-up and an average 5 years'. There was no complication, and all the patients operated on resumed an active work at the fifth postoperative month on average. Early rehabilitation was favoured by bone fixation of the first metacarpal with an intramedullary peg, and by careful cinematisation (reinsertion of all extensors, cinematisation by the flexor pollicis longus). The results showed that this procedure was the surgery of choice for isolated amputations of the thumb occurring in manual workers at the level of or above the MP. Indeed, if it is compared with transfers of the 2nd toe, pollicisation is characterized by its reliability, an early return to work, a greater range of active motion (60 degrees instead of 30 degrees), pulp-pinch and key-pinch figures at 54 per cent, a hand-grasp (70 per cent) identical or better, a touch sensibility two or three times as good (Weber at 5 mm), a better cold tolerance (no professional disability), and by the fact that there is no discomfort at the level where the transplanted digit was removed.