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Ulnar polydactyly: long-term outcomes and cost-effectiveness of surgical clip application in the newborn
Janith K Mills1, Marybeth Ezaki, Scott N Oishi
11Texas Scottish Rite Hospital for Children, Dallas, TX, USA.
Background:
Postaxial polydactyly type B (PAPD-B) refers to the nonfunctional, floppy extra digit on the ulnar border of the hand. Suture ligation is applied in the newborn unit if the base is narrow or pedunculated. However, wart-like scars, residual bumps, or neuromas are frequent complications. Wider-based extra digits are treated at a later age by surgical excision under general anesthesia. Surgical clip application expands the indications for PAPD treatment in the newborn unit or outpatient setting with lesser incidences of complications.
Design:
A retrospective review identified 231 hands with PAPD-B in 132 newborns treated with surgical clips between January 1, 1996, and November 30, 2010, having a minimum of 2 years of follow-up. Medical records were queried for complications, revision procedures, and parent satisfaction. A relative cost survey compares the costs of surgical clips to surgery.
Conclusions:
In all, 16 extremities in 9 patients (7%) required surgical scar revision. No wound complications were noted.
