PollicizationPPollicizationPollicizationEnglishPlasticsToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)HandNAProceduresCaregivers Adult (19+)NA2011-07-07T04:00:00ZJocelyne Copeland BA, BHSc OT, OT Reg (ON)7.1000000000000067.7000000000000934.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Some children are born without a thumb. In a procedure called pollicization, doctors can reposition the index finger to make it work like a thumb.</p><figure> <span class="asset-image-title">Pollicization of right hand</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_MED_ILL_EN.jpg" alt="Hand with index finger slid into new thumb position and original position of index finger indicated with dotted line" /> <figcaption class="asset-image-caption">A surgeon shortens one of the bones in the index finger. The surgeon then slides the shortened index finger into the thumb position. The index finger is not amputated and replanted.</figcaption> </figure> <p>Some children are born without a thumb or with an underdeveloped thumb that does not work. In some cases, surgeons can reposition the index finger to make it work like a thumb. This surgical procedure is called pollicization.</p><p>Your surgeon will discuss this surgical option with you and determine whether your child is a good candidate. A child who is consistently trying to use their index finger like a thumb is usually a good candidate.</p><h2>Key Points</h2> <ul> <li>Pollicization is a procedure in which surgeons reposition the index finger to make it work like a thumb. </li> <li>A child who is consistently trying to use their index finger like a thumb is usually a good candidate.</li> <li>Surgeons shorten and position the finger so that it looks as much like a thumb as possible.</li> <li>A good age to consider pollicization is when your child is a toddler. </li> <li>The new thumb will be thinner than a typical thumb. But it will be the right length, in the right position and will work like a thumb.</li> <li>The occupational therapist teaches your child stretches and activities so they can use their new thumb to its full potential.</li> <li>With the help of the occupational therapist, your child's thumb should be fully functional about 12 weeks after the surgery.</li> </ul><h2>At what age is the procedure done?</h2> <p>Surgeons do not perform pollicization at a specific age. In fact, doctors will likely ask you to wait and see how your child uses their fingers and thumb to grasp and hold objects. This helps them decide whether pollicization is the best option for your child.</p> <h3>Newborns </h3> <p>Although many parents want to do something as soon as possible, newborns are too young to find their preferred grasp patterns and too tiny for complex surgery.</p> <h3>Toddlers</h3> <p>A good age to consider pollicization is when your child is a toddler. Toddlers are naturally exploring their hand skills and can easily grasp patterns. This makes therapy after surgery easier. Also, post-operative therapy is minimal since toddlers tend to do their own therapy through play!</p> <h3>Teens</h3> <p>Children, who did not have pollicization done at a young age, sometimes decide as teens they would like this surgery. Although surgery can be done during this age, it is a bit more challenging because we become more prone to stiffness as we age.</p> <h3>What happens during the procedure?</h3> <p>After removing the thumb, the surgeons shorten one of the bones in the index finger. They then slide the shortened index finger (including all its tendons and nerves) into the thumb position. The index finger is NOT amputated and replanted. It remains attached at all times. Your child will be under general anaesthesia during the surgery.</p><h2>After surgery</h2><h3>What does the new thumb look like?</h3><p>After the procedure, your child will have a scar at the base of the new thumb. The surgeons shorten and position the finger so that it looks as much like a thumb as possible. Many times, people have to do a double take: they count the fingers to convince themselves there is one missing.</p><h3>How long would my child be in hospital?</h3><p>Usually, your child stays in hospital for one night after the surgery. If your child is feeling well the next day, you will be able to go home.</p><p>After surgery, your child may need to wear a splint to protect the new thumb. Your surgeon and occupational therapist will discuss this with you in more detail.</p><h3>Does the thumb actually work?</h3><p>The new thumb will always be thinner than a typical thumb. But it will be the right length and in the right position. Best of all, it will work like a thumb.</p><p>Before surgery: your child can only pick up objects using the space between their fingers.</p><p>After surgery: Your child will be able to grasp small and large objects.<br></p> <figure class="asset-c-80"> <span class="asset-image-title">Grip before and after pollicization</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_grip_MED_ILL_EN.png" alt="Hand before pollicization gripping pen between fingers and hand after with a larger grip, holding pen between fingertips" /> <figcaption class="asset-image-caption">Before surgery your child can only pick up objects using the space between their fingers. After surgery, your child will be able to pinch objects with the tips of their fingers. The new "thumb" will also allow them to grasp larger objects.</figcaption> </figure> <h3>Will my child need therapy?</h3><p>Yes. The occupational therapist teaches your child stretches and activities so they can use their new thumb to its full potential. They suggest activities you can do at home as well. </p><p>The occupational therapist monitors your child's progress every few weeks. They will do this either at the hospital or a location closer to your home. </p><h3>How long will it take to heal?</h3><p>After about four weeks, the bones start to heal and your therapist will help your child move the thumb.</p><p>Over the next eight weeks, your child will progress from using their thumb with light resistance to full range of motion and full resistance. There will likely be redness and slightly raised scarring at the base of the thumb, which will take several months to heal.</p><p>About 12 weeks after surgery, your child's thumb should be fully functional. Your child will be able to use their thumb on their own and no longer need to continue with therapy. The scars may still appear red and raised. Continue massaging the scars with Vaseline. </p><p>For more information, please see <a href="/Article?contentid=942&language=English">Congenital hand anomaly (hand difference)</a>.</p>
PollicisationPPollicisationPollicizationFrenchPlasticsToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)HandNAProceduresCaregivers Adult (19+)NA2011-07-07T04:00:00ZJocelyne Copeland BA, BHSc OT, OT Reg (ON)Health (A-Z) - ProcedureHealth A-Z<p>Certains enfants naissent sans pouce. Grâce à une intervention appelée pollicisation, le chirurgien peut repositionner l’index de manière à ce que ce dernier fonctionne comme un pouce.</p><figure> <span class="asset-image-title">Pollicisation de la main droite</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_MED_ILL_FR.jpg" alt="La main droite avec l'index glissé en position du pouce. Une ligne pointillée montre la position initiale de l'index" /> <figcaption class="asset-image-caption">Le chirurgien raccourcit les os de l’index. Il glisse ensuite ce dernier dans la position du pouce. L’index n’est pas amputé et réimplanté.</figcaption> </figure> <p>Certains enfants naissent sans pouce ou avec un pouce mal développé qui ne fonctionne pas. Dans certains cas, le chirurgien peut repositionner l’index pour le faire fonctionner comme un pouce. Cette intervention chirurgicale s’appelle pollicisation.</p><p>Votre chirurgien discutera de cette option avec vous et déterminera si elle serait indiquée pour votre enfant. Un enfant qui essaie constamment d’utiliser son index comme un pouce est habituellement un bon candidat pour cette intervention.</p><h2>À retenir</h2><ul><li>La pollicisation est une intervention au cours de laquelle le chirurgien repositionne l’index de la main pour faire en sorte qu’il fonctionne comme un pouce.</li><li>Un enfant qui essaie constamment d’utiliser son index comme un pouce est habituellement un bon candidat pour une telle intervention.</li><li>Le chirurgien raccourcit et repositionne le doigt de manière à ce qu’il ressemble le plus possible à un pouce.</li><li>Un bon moment pour envisager la pollicisation est quand votre enfant a 2 ou 3 ans.</li><li>Le nouveau pouce sera plus mince qu’un pouce ordinaire, mais il sera de la bonne longueur et fonctionnera comme un pouce.</li><li>L’ergothérapeute montrera à votre enfant des exercices d’étirement et des activités qui lui permettront d’utiliser son nouveau pouce à son plein potentiel.</li><li>Avec l’aide de l’ergothérapeute, le pouce de votre enfant devrait être pleinement fonctionnel environ 12 semaines après l’intervention.<br></li></ul><h2>À quel âge cette intervention est-elle pratiquée?</h2><p>Il n’y a pas d’âge précis pour pratiquer la pollicisation. En fait, les médecins vous demanderont probablement d’attendre et de voir comment votre enfant utilise ses doigts et son pouce pour saisir et tenir des objets. Cela les aidera à déterminer si la pollicisation est la meilleure option pour votre enfant.</p><h3>Nouveau-nés</h3><p>Même si bon nombre de parents voudront corriger la malformation le plus tôt possible, les nouveau-nés sont trop jeunes pour déterminer comment ils préfèrent saisir les objets et ils sont trop petits pour subir des interventions chirurgicales complexes.</p><h3>Enfants de 2 ou 3 ans</h3><p>C’est un bon âge pour envisager de faire opérer votre enfant. À cet âge, les enfants ont naturellement tendance à explorer leur dextérité manuelle et peuvent facilement se réadapter. Cela facilite la réadaptation post-opératoire, qui sera minimale puisqu’ils tendent à faire leur propre réadaptation par le jeu!</p><h3>Adolescents</h3><p>Les enfants qui n’ont pas subi une pollicisation à un jeune âge voudront parfois se faire opérer à l’adolescence. Bien que l’intervention puisse être pratiquée à cet âge, elle sera un peu plus difficile parce que notre corps a tendance à se raidir à mesure que nous vieillissons.</p><h3>Comment se déroule l’intervention?</h3><p>Après avoir enlevé le pouce, le chirurgien raccourcit un des os de l’index. Puis il fait glisser l’index raccourci (avec tous ses nerfs et tendons) à l’endroit où se trouvait le pouce. L’index n’est pas amputé et réimplanté, mais reste attaché en tout temps. Votre enfant sera placé sous anesthésie générale pendant l’intervention.</p><h2>Après l’intervention</h2><h3>À quoi ressemble le nouveau pouce?</h3><p>Après l’intervention, votre enfant aura une cicatrice à la base du nouveau pouce. Les chirurgiens raccourcissent et positionnent l’index de manière à ce qu’il ressemble le plus possible à un pouce. Souvent, les gens n’en croient pas leurs yeux et doivent compter les doigts pour se convaincre qu’il en manque bien un.</p><h3>Pendant combien de temps mon enfant devra‑t‑il rester à l’hôpital?</h3><p>Normalement, votre enfant passera la nuit à l’hôpital après l’opération. S’il se sent bien le lendemain, vous pourrez le ramener à la maison.</p><p>Après l’intervention, votre enfant devra peut-être porter une attelle pour protéger le nouveau pouce. Votre chirurgien et votre ergothérapeute en discuteront avec vous plus en détail.</p><h3>Est-ce que le pouce fonctionne réellement?</h3><p>Le nouveau pouce sera toujours un peu plus mince qu’un pouce normal, mais il sera de la bonne longueur et sera dans la bonne position. Et, surtout, il fonctionnera comme un vrai pouce.</p><p>Avant l’intervention : Votre enfant ne peut saisir des objets qu’en utilisant l’espace entre ses doigts.</p><p>Après l’intervention : Votre enfant pourra saisir des objets petits et gros.</p> <figure class="asset-c-80"> <span class="asset-image-title">Préhension avant et après la pollicisation</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_grip_MED_ILL_FR.png" alt="Une main tenant un objet en utilisant l'espace entre les doigts, et une main pincant des objets avec le bout des doigts" /> <figcaption class="asset-image-caption">Avant l’intervention, votre enfant ne peut saisir des objets qu’en utilisant l’espace entre ses doigts. Après l’opération, votre enfant pourra pincer des objets avec l’extrémité de ses doigts. Le nouveau « pouce » lui permettra aussi de saisir des objets plus gros.</figcaption> </figure> <h3>Mon enfant aura-t-il besoin de réadaptation?</h3><p>Oui. L’ergothérapeute lui montrera des exercices d’étirement et des activités qu’il pourra faire pour l’aider à utiliser son nouveau pouce à son plein potentiel. Il suggérera aussi des activités qu’il pourra faire à la maison.</p><p>L’ergothérapeute évaluera les progrès de votre enfant à quelques semaines d’intervalle. Ces séances de suivi auront lieu à l’hôpital ou à un autre endroit plus près de chez vous.</p><h3>Combien de temps la guérison prendra‑t‑elle?</h3><p>Après environ quatre semaines, les os commenceront à guérir et votre thérapeute aidera votre enfant à bouger son pouce.</p><p>Dans les huit semaines qui suivront, votre enfant apprendra progressivement à utiliser son pouce avec une faible résistance jusqu’à pouvoir exécuter une gamme complète de mouvements avec une pleine résistance. Il y aura probablement de la rougeur et des cicatrices légèrement surélevées à la base du pouce; ces phénomènes disparaîtront après quelques mois.</p><p>Environ 12 semaines après l’intervention, le pouce de votre enfant devrait être pleinement fonctionnel. Il pourra utiliser son pouce tout seul et n’aura plus besoin de réadaptation. Les cicatrices seront peut-être encore rouges et surélevées; continuez de les masser avec de la vaseline.</p><p>Pour plus de renseignements, consulter <a href="/Article?contentid=942&language=French">Anomalie congénitale de la main (main différente)</a>.</p>

 

 

 

 

Pollicization1025.00000000000PollicizationPollicizationPEnglishPlasticsToddler (13-24 months);Preschooler (2-4 years);School age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)HandNAProceduresCaregivers Adult (19+)NA2011-07-07T04:00:00ZJocelyne Copeland BA, BHSc OT, OT Reg (ON)7.1000000000000067.7000000000000934.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Some children are born without a thumb. In a procedure called pollicization, doctors can reposition the index finger to make it work like a thumb.</p><figure> <span class="asset-image-title">Pollicization of right hand</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_MED_ILL_EN.jpg" alt="Hand with index finger slid into new thumb position and original position of index finger indicated with dotted line" /> <figcaption class="asset-image-caption">A surgeon shortens one of the bones in the index finger. The surgeon then slides the shortened index finger into the thumb position. The index finger is not amputated and replanted.</figcaption> </figure> <p>Some children are born without a thumb or with an underdeveloped thumb that does not work. In some cases, surgeons can reposition the index finger to make it work like a thumb. This surgical procedure is called pollicization.</p><p>Your surgeon will discuss this surgical option with you and determine whether your child is a good candidate. A child who is consistently trying to use their index finger like a thumb is usually a good candidate.</p><h2>Key Points</h2> <ul> <li>Pollicization is a procedure in which surgeons reposition the index finger to make it work like a thumb. </li> <li>A child who is consistently trying to use their index finger like a thumb is usually a good candidate.</li> <li>Surgeons shorten and position the finger so that it looks as much like a thumb as possible.</li> <li>A good age to consider pollicization is when your child is a toddler. </li> <li>The new thumb will be thinner than a typical thumb. But it will be the right length, in the right position and will work like a thumb.</li> <li>The occupational therapist teaches your child stretches and activities so they can use their new thumb to its full potential.</li> <li>With the help of the occupational therapist, your child's thumb should be fully functional about 12 weeks after the surgery.</li> </ul><h2>At what age is the procedure done?</h2> <p>Surgeons do not perform pollicization at a specific age. In fact, doctors will likely ask you to wait and see how your child uses their fingers and thumb to grasp and hold objects. This helps them decide whether pollicization is the best option for your child.</p> <h3>Newborns </h3> <p>Although many parents want to do something as soon as possible, newborns are too young to find their preferred grasp patterns and too tiny for complex surgery.</p> <h3>Toddlers</h3> <p>A good age to consider pollicization is when your child is a toddler. Toddlers are naturally exploring their hand skills and can easily grasp patterns. This makes therapy after surgery easier. Also, post-operative therapy is minimal since toddlers tend to do their own therapy through play!</p> <h3>Teens</h3> <p>Children, who did not have pollicization done at a young age, sometimes decide as teens they would like this surgery. Although surgery can be done during this age, it is a bit more challenging because we become more prone to stiffness as we age.</p> <h3>What happens during the procedure?</h3> <p>After removing the thumb, the surgeons shorten one of the bones in the index finger. They then slide the shortened index finger (including all its tendons and nerves) into the thumb position. The index finger is NOT amputated and replanted. It remains attached at all times. Your child will be under general anaesthesia during the surgery.</p><h2>After surgery</h2><h3>What does the new thumb look like?</h3><p>After the procedure, your child will have a scar at the base of the new thumb. The surgeons shorten and position the finger so that it looks as much like a thumb as possible. Many times, people have to do a double take: they count the fingers to convince themselves there is one missing.</p><h3>How long would my child be in hospital?</h3><p>Usually, your child stays in hospital for one night after the surgery. If your child is feeling well the next day, you will be able to go home.</p><p>After surgery, your child may need to wear a splint to protect the new thumb. Your surgeon and occupational therapist will discuss this with you in more detail.</p><h3>Does the thumb actually work?</h3><p>The new thumb will always be thinner than a typical thumb. But it will be the right length and in the right position. Best of all, it will work like a thumb.</p><p>Before surgery: your child can only pick up objects using the space between their fingers.</p><p>After surgery: Your child will be able to grasp small and large objects.<br></p> <figure class="asset-c-80"> <span class="asset-image-title">Grip before and after pollicization</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Pollicization_grip_MED_ILL_EN.png" alt="Hand before pollicization gripping pen between fingers and hand after with a larger grip, holding pen between fingertips" /> <figcaption class="asset-image-caption">Before surgery your child can only pick up objects using the space between their fingers. After surgery, your child will be able to pinch objects with the tips of their fingers. The new "thumb" will also allow them to grasp larger objects.</figcaption> </figure> <h3>Will my child need therapy?</h3><p>Yes. The occupational therapist teaches your child stretches and activities so they can use their new thumb to its full potential. They suggest activities you can do at home as well. </p><p>The occupational therapist monitors your child's progress every few weeks. They will do this either at the hospital or a location closer to your home. </p><h3>How long will it take to heal?</h3><p>After about four weeks, the bones start to heal and your therapist will help your child move the thumb.</p><p>Over the next eight weeks, your child will progress from using their thumb with light resistance to full range of motion and full resistance. There will likely be redness and slightly raised scarring at the base of the thumb, which will take several months to heal.</p><p>About 12 weeks after surgery, your child's thumb should be fully functional. Your child will be able to use their thumb on their own and no longer need to continue with therapy. The scars may still appear red and raised. Continue massaging the scars with Vaseline. </p><p>For more information, please see <a href="/Article?contentid=942&language=English">Congenital hand anomaly (hand difference)</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Pollicization_MED_ILL_EN.jpgPollicizationFalse