Pollicisation is a surgical procedure in which the index finger is carefully repositioned to function as a new thumb. The index finger is detached from its base, rotated and shortened, and reattached in the position of the absent thumb, with its nerves, blood vessels, and tendons kept intact throughout the transfer. It is recommended for severe thumb hypoplasia where the existing thumb lacks the critical structures needed for function, and for complete thumb absence. Pollicisation is performed in early childhood, typically between one and two years of age, so the child's brain and motor system can adapt to the new thumb during the critical window of motor learning.

Yes, for milder degrees of thumb hypoplasia where the key joints, tendons, and muscles are present but dysfunctional or unstable, reconstruction of the existing thumb is a viable and effective approach. This may involve stabilising the joints, reconstructing the tendons, deepening the web space, or correcting the position of the thumb. The decision between reconstruction and pollicisation is based on the classification of the hypoplasia. At Galwa Care Hospital, this decision is made carefully and explained thoroughly to parents, ensuring they understand the rationale and the expected outcomes of the chosen approach.

Recovery after thumb reconstruction or pollicisation involves a period of immobilisation while the surgical repairs heal, followed by a structured hand therapy and occupational therapy programme. Therapy is crucial because it teaches the child to use the reconstructed or newly created thumb, building the strength, coordination, and motor patterns needed for normal hand function. The process takes time and is supported throughout by the therapy team at Galwa Care Hospital. Most children adapt remarkably well to their reconstructed hand, with significant functional improvement becoming apparent progressively over the months following surgery.

With appropriate surgical technique and dedicated post-operative therapy, the outcomes of thumb hypoplasia surgery at Galwa Care Hospital are consistently positive. Reconstructed thumbs and pollicised fingers grow with the child and develop into functionally useful, proportionate digits that support grip, pinch, and fine motor skills. While the outcome varies depending on the degree of original hypoplasia and the complexity of the reconstruction, the vast majority of children treated early achieve meaningful hand function that enables normal participation in school, sport, play, and daily life. Long-term follow-up ensures that any evolving needs are identified and addressed promptly.