TY - JOUR
T1 - Long-term outcomes following radial polydactyly reconstruction
AU - Stutz, Chris
AU - Mills, Janith
AU - Wheeler, Lesley
AU - Ezaki, Marybeth
AU - Oishi, Scott
PY - 2014/8
Y1 - 2014/8
N2 - Purpose To report long-term outcomes (> 10 y) after radial polydactyly reconstruction. Methods We evaluated 43 surgically reconstructed thumbs in 41 patients with radial polydactyly whom we had observed for more than 10 years. The study group included 12 Flatt type II, 8 type III, 17 type IV, and 6 type V. The average age of surgery was 1 year and mean follow-up was 17 years. Objective outcome values and validated patient-oriented outcome evaluations were obtained. Results No early postsurgical complications were encountered. Eight patients had 10 revision procedures at an average of 8 years after the initial procedure. Five patients had interphalangeal joint arthrodesis, all for angulation with accompanying pain. The average Tada score was 4.1. Lateral, tripod, and tip pinch strengths were 96%, 86%, and 92%, respectively, of the unaffected side. As a group, the treated thumbs had significantly weaker tip and tripod pinch strengths than the untreated thumbs. The average Disabilities of the Arm, Shoulder, and Hand score was 4.5 and the average Pediatric Quality of Life Inventory score was 87 when administered to both the patient and the parent. Conclusions Long-term results after surgical reconstruction for radial polydactyly were excellent but the revision rate trended upward over time despite maintenance of favorable scores on the objective outcome measures used. Type of study/level of evidence Therapeutic IV.
AB - Purpose To report long-term outcomes (> 10 y) after radial polydactyly reconstruction. Methods We evaluated 43 surgically reconstructed thumbs in 41 patients with radial polydactyly whom we had observed for more than 10 years. The study group included 12 Flatt type II, 8 type III, 17 type IV, and 6 type V. The average age of surgery was 1 year and mean follow-up was 17 years. Objective outcome values and validated patient-oriented outcome evaluations were obtained. Results No early postsurgical complications were encountered. Eight patients had 10 revision procedures at an average of 8 years after the initial procedure. Five patients had interphalangeal joint arthrodesis, all for angulation with accompanying pain. The average Tada score was 4.1. Lateral, tripod, and tip pinch strengths were 96%, 86%, and 92%, respectively, of the unaffected side. As a group, the treated thumbs had significantly weaker tip and tripod pinch strengths than the untreated thumbs. The average Disabilities of the Arm, Shoulder, and Hand score was 4.5 and the average Pediatric Quality of Life Inventory score was 87 when administered to both the patient and the parent. Conclusions Long-term results after surgical reconstruction for radial polydactyly were excellent but the revision rate trended upward over time despite maintenance of favorable scores on the objective outcome measures used. Type of study/level of evidence Therapeutic IV.
KW - Preaxial polydactyly
KW - radial polydactyly split thumbs
KW - thumb duplication
KW - thumb polydactyly
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U2 - 10.1016/j.jhsa.2014.05.006
DO - 10.1016/j.jhsa.2014.05.006
M3 - Article
C2 - 24996673
AN - SCOPUS:84905091372
SN - 0363-5023
VL - 39
SP - 1549
EP - 1552
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 8
ER -