We have examined 11 patients with aplasia of the thumb and we have treated by pollicization of the index finger. We have conducted a follow up of 5 years. The total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation. The absent thumb is as an autosomal dominant pathology or may be sporadic. It is frequently observed in the Holt-Oram syndrome, Fanconi's anemia, and ring D chromosome abnormalities. It is occasionally observed in the Rothmund syndrome, trisomy, thalidomide embryopathology and other congenital syndromes. An absent radius is almost always associated with an absent thumb, except in thrombocytopenia radial aplasia (Fanconi's syndrome), where the thumb is present even when the radius is absent. The treatment in most cases of the absent thumb is to perform a pollicization of the index finger. Our isolated congenital absence of the thumb patients have been treated with pollicization as described by Buck-Gramcko works well. It is a beautiful operation for the congenitally deformed, aplastic, or missing thumb. Pollicization of the index finger gives good functional and cosmetic results which are maintained.
Conclusions: The total absence of the thumb in the congenitally pathology gives the hand of the patient insufficient in the functional movement and no cosmetic. So the pollicization with the second index fined gives a good reconstruction for the neo-thumb. In our five years follow-up, the 11 young patients that were treated with the pollicization, they are satisfy and use the neo-thumb like normal thumb. In congenitally absent thumbs clearly support the fact that the pollicized digit is used by most patients and is not ignored or bypassed.