Digital Transposition in the Injured Hand

¹ From the Orthopaedic Service, Walter Reed General Hospital, Washington, D. C.

1. In twenty of twenty-one cases of transposition of a digit to replace an amputated thumb the results were excellent or satisfactory as to pinch, opposition, and sensibility.

2. The damaged or least useful remaining damaged digit should be used for pollicization when possible.

3. Digital transfers can be safely performed with a single intact digital artery and even on a metacarpal artery in the case of the index finger in the absence of functioning digital arteries.

4. Preservation of a dorsal vein is desirable but not essential in digital transposition. It is difficult when the long finger is transferred and impossible for the ring finger.

5. The presence of a remnant of the thumb metacarpal facilitates the procedure and greatly improves the results.

6. The position of rotation of the pollicized digit is best determined by the orientation of the remnants of metacarpal and thenar mass. When thenar muscle mass and metacarpal are not present, rotation should approximate 120 degrees to the digital plane.

7. Secondary procedures are to be expected in the reconstruction program and pollicization is but one of the essential procedures in the process of rehabilitation of a severely damaged hand.

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