Office-Based Post-Axial Polydactyly Excision in Neonates, Infants, and Children
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Published on: September 16, 2022
Christopher L Carpenter1, Trajan A Cuellar, Michael T Friel
1Jackson, Miss. From the University of Mississippi Medical Center.
Insights
Office-based surgical excision of type B postaxial polydactyly in children is safe and effective. This approach avoids general anesthesia and offers improved healthcare utilization for this common congenital hand difference.
Area of Science:
- Pediatric Hand Surgery
- Congenital Hand Malformations
- Office-Based Procedures
Background:
- Limited literature exists on office-based hand surgery in pediatric populations.
- Polydactyly is a common congenital hand malformation.
- Type B postaxial polydactyly is frequently encountered.
Purpose of the Study:
- To present a case series of in-office surgical excision of type B postaxial polydactyly in infants and children.
- To evaluate the healthcare utilization benefits of office-based procedures.
- To assess the safety and efficacy of avoiding general anesthesia.
Main Methods:
- Retrospective review of patients undergoing in-office excision.
- Documentation of the surgical technique for type B postaxial polydactyly excision.
- Use of lidocaine with epinephrine for local anesthesia.
Main Results:
- Twenty-six children were treated for postaxial polydactyly over 15 months.
- Average age at excision was 3.3 months (median 1.4 months).
- No post-procedure complications affecting function or sensation were reported.
Conclusions:
- Successful in-office surgical excision of type B postaxial polydactyly is feasible in newborns, infants, and children.
- This cost-conscious approach avoids general anesthesia, enhancing safety.
- The technique demonstrates excellent results without compromising quality of care.
Background:
In adult hand surgery literature, there are multiple publications highlighting the successful use of office-based hand surgery in the treatment of hand conditions. There are few instances of office-based hand surgery in the pediatric population present in the literature. Polydactyly of the hand is one of the most common congenital hand malformations. The authors present a case series of successfully performed in-office surgical excision of the type B postaxial polydactylous digit in infants and children. The added health care utilization improvements by performing this in the office, as well as lack of exposure to general anesthesia are reviewed.
Methods:
A retrospective review of the patients treated was completed and the technique of in-office excision documented.
Results:
Over a 15 month period, a total of twenty-six children were treated in the office for postaxial polydactyly. The average age of the child at the time of excision was 3.3 months old, with a median of 1.4 months with a range of 9 days-4.2 years. There were no postprocedure complications in function or sensation.
Conclusions:
The authors report a case series of successful surgical excision of type B postaxial polydactyly in newborns, infants, and children in an office setting with the use of lidocaine with epinephrine. This technique is a cost-conscious approach to the condition without the need for general anesthesia. This demonstrates excellent results with improved safety without sacrificing quality.
Clinical Question/Level Of Evidence:
Therapeutic, IV.
