Children born without a thumb may undergo a pollicization procedure where the index finger is moved to the radial base of the hand to become a functional thumb. Although the new “thumb” may not have thenar muscles, the position of the new digit allows functional opposition.
Initial post-operative therapy initially concentrates on protection of the newly constructed thumb but quickly shifts to a focus on practical use. The ability of a young patient to functionally integrate the new thumb is a vivid demonstration of brain plasticity as the sensorimotor cortex redefines the thumb and its new movement.
An article on this subject can be found online without charge: Kozin SH. Pollicization: the concept, technical details, and outcome. Clinics in Orthopedic Surgery March 2012; 4(1): 18–35; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3288492/
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