Outcome After Pollicization for Congenital Thumb Deficiency: A Cohort Study of Cases in a Single Unit, 1987 to 2016

Abstract

Purpose To investigate the functional and aesthetic outcomes in a cohort with pollicizations performed due to congenital anomalies in our hospital.Methods From 1987 to 2016, we performed pollicizations in 32 hands of children aged 1 to 8 years (median, 2 years). We followed-up on 31 of the hands from 1 to 31 years (median, 10 years) after the procedure. The participants and their caregivers self-assessed their function and appearance with visual analogue scales and patient-reported outcome measures (Patient-Reported Outcomes Measurement Information System Pediatric Upper Extremity; the short version of the Disability of Arm, Shoulder and Hand Outcome Measure; and EQ-5D-3L). We examined the hands with regard to motion, strength, sensitivity, and function.Results There were 2 complications and 6 reoperations. Participants with mild anomalies (radial longitudinal deficiency Bayne type N/0 to 2) had better subjective and objective hand function than participants with severe anomalies (radial longitudinal deficiency Bayne type 3e4, ulnar dimelia, 5-finger hand). Hands with preoperatively near-normal index fingers had, in most cases, good thumb opposition and pinch, and hands in both groups benefited from the creation of a cylinder grip. Grip and pinch strength were lower than reported in cohort studies where an additional opponensplasty had been performed.Conclusions Hands with severe congenital anomalies also benefited from the procedure. We recommend a simplified follow-up program to identify cases where additional surgeries to enhance strength should be considered during growth of the child.

PROMIS Utilization in Pediatric Orthopaedics: A Scoping Review

“…A total of 51 studies8–10,17–64 of PROMIS in pediatric orthopaedics were identified in the current review. Study characteristics by year, author, orthopaedic population, topic, and cohort size can be found in Appendix, Supplemental Digital Content 1, http://links.lww.com/BPO/A524.…”

“…For the purposes of this review, patients were grouped by body part or subspecialty. Most studies were included within the “Hand and Upper Extremity”10,23–34 (25.5%, n=13) and “Sports”47–58 (23.5%, n=12) categories followed by “Spine”8,41–46 (13.7%, n=7), “Trauma”9,59–64 (13.7%, n=7), “General Pediatric Orthopaedics”17–22 (11.8%, n=6), “Lower Extremity”35–39 (9.8%, n=5), and “Orthopaedic Oncology”40 (2%, n=1).…”

“…1). Two 26,47 of the included studies had patients > 18 years old utilizing adult PROMIS forms but this data was able to be separated from the pediatric patient data. Data extraction were performed by 2 authors in parallel (blinded).…”

“…There were 1961 unique citations included after the removal of 1756 duplicates. After initial screening, 183 studies were screened under full-text review leaving a final number of 51 studies8–10,17–64 included in this scoping review (Fig. 1).…”

“…The methodology of the studies included 3 categories: (1) Outcome studies [8][9][10]17,18,[23][24][25][26][27][28][29][30][34][35][36][37][38][40][41][42]47,48,55,57,[59][60][61][62][63][64] in which baseline PROMIS scores were assessed in a specific disease state or to evaluate the outcome of a surgical procedure or treatment (n = 31, 60.8%), (2) PROM comparison studies 8,[19][20][21][22][23]29,31,33,39,41,[43][44][45][46]49,54,56,58 in which PROMIS was compared with a legacy PROM within a ...…”