Long term functional outcomes after early childhood pollicization

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Abstract

Study design:

Retrospective Cohort

Introduction:

Important outcomes of polliciation to treat thumb hypoplasia/aplasia include strength, function, dexterity, and quality of life.

Purpose of the Study:

To evaluate outcomes and examine predictors of outcome after early childhood pollicization.

Methods:

8 children (10 hands) were evaluated 3–15 years after surgery. Physical examination, questionnaires, grip and pinch strength, Box and Blocks, 9-hole pegboard, and strength-dexterity (S-D) tests were performed.

Results:

Pollicized hands had poor strength and performance on functional tests. Six of 10 pollicized hands had normal dexterity scores but less stability in maintaining a steady-state force. Predictors of poorer outcomes included older age at surgery, reduced metacarpophalangeal and interphalangeal range of motion, and radial absence.

Discussion:

Pollicization resulted in poor strength and overall function, but normal dexterity was often achieved using altered control strategies.

Conclusions:

Most children should obtain adequate dexterity despite weakness after pollicization except older or severely involved children.

Level of evidence:

IV

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