Patient-Reported Outcomes after Syndactyly Reconstruction

Abstract

Background: There is scant literature regarding patient-reported outcomes after reconstruction for congenital hand syndactyly. Understanding patient perceptions of the postoperative outcome may facilitate a more evidence-based discussion of expectations after reconstruction. Methods: All patients undergoing congenital syndactyly reconstruction at Ann and Robert H. Lurie Children’s Hospital of Chicago between January of 2007 and December of 2015 were identified. Patient-Reported Outcomes Measurement Information System questionnaires were completed by patients; parent-proxy questionnaires were completed for patients 10 years of age and younger and those unable to complete the questionnaire independently. A retrospective chart review was also performed to capture demographic and clinical information. Results: The authors identified 124 patients meeting inclusion criteria; 51 completed the Patient-Reported Outcomes Measurement Information System surveys (response rate, 41.1 percent). The survey score for upper extremity function was 41.8 ± 11. Upper extremity function was further impaired in patients with a documented history of developmental delay (23.8 ± 6.2 versus 44.2 ± 10.2). Parents completing surveys on behalf of their children reported higher pain interference scores than self-responders. Conclusions: The Patient-Reported Outcomes Measurement Information System is a valuable tool for measuring patient-reported outcomes in patients with syndactyly. Patients who have undergone reconstruction for syndactyly experience minor impairments in upper extremity function, but other aspects of their health-related quality of life are comparable to those of the general population. Developmental delay may be associated with additional impairments in upper extremity function and should be discussed when considering surgical reconstruction.

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.…”

“…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 ...…”

“…Pediatric versions of PROMIS (aged 5-17 y) have been created for use in the pediatric setting, including a special parent proxy version for those aged 5 through 7. 7 In orthopaedic clinical research, PROMIS has become widely adopted and is represented in almost every subspecialty [8][9][10] and age group. 11,12 A recent systematic review by Horn et al 13 evaluated PROMIS use in the adult orthopaedic population ( > 18 y old) yielding 88 studies but did not assess its utilization in the pediatric population.…”

“…In orthopaedic clinical research, PROMIS has become widely adopted and is represented in almost every subspecialty8–10 and age group 11,12. A recent systematic review by Horn et al13 evaluated PROMIS use in the adult orthopaedic population (>18 y old) yielding 88 studies but did not assess its utilization in the pediatric population.…”