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Functional outcome for children with thumb aplasia undergoing pollicization
Kimberly Goldie Staines1, Ramsey Majzoub, John Thornby
1HealthSouth, Baylor College of Medicine, St. Luke's Episcopal Hospital, Houston, Texas, USA.
Plastic and Reconstructive Surgery
|October 12, 2005
Summary
Pollicization surgery for congenital thumb aplasia improves appearance and social interaction, though grip and pinch strength are reduced. Comprehensive functional assessments are crucial for evaluating outcomes in pediatric hand surgery.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Developmental Pediatrics
Background:
- Evaluating hand function in young patients presents challenges.
- Assessing functional recovery after surgery for congenital anomalies is vital for developmental progress.
Purpose of the Study:
- To evaluate the functional outcomes of pollicization surgery in children with congenital thumb aplasia.
- To assess the impact of pollicization on hand function, strength, and patient-reported satisfaction.
Main Methods:
- 10 children (12 extremities) with prior pollicization for thumb aplasia underwent evaluation.
- Methods included radiographs, range of motion, grip/pinch strength, parent questionnaires, and functional tests (Jebsen, Functional Dexterity Test).
Main Results:
- Operated hands showed significantly reduced grip (2 kg vs. 5.6 kg) and pinch strength (1.0 kg vs. 2.1 kg) compared to non-operated hands.
- While range of motion and overall Jebsen test times were comparable, specific tasks like checker stacking and page turning showed differences.
- Children reported satisfaction with appearance and social interactions, but difficulties handling small objects requiring pinch strength were noted.
Conclusions:
- Pollicization is a beneficial procedure for children with thumb aplasia.
- Comprehensive, multi-faceted functional outcome evaluations using age-appropriate norms are essential for congenital hand conditions.