Long-Term Outcomes After Treatment for Type B Ulnar Polydactyly

Area of Science:

• Hand Surgery
• Congenital Hand Differences
• Pediatric Orthopedics

Background:

• Type B ulnar polydactyly is a common congenital hand difference.
• Treatment options include ligation and surgical excision.
• Limited data exists on long-term patient-reported outcomes for these treatments.

Purpose of the Study:

• To compare long-term outcomes of ligation versus surgical excision for type B ulnar polydactyly.
• To evaluate patient satisfaction and functional results.
• To identify potential complications associated with each treatment modality.

Main Methods:

• Retrospective review of patients treated for type B ulnar polydactyly (2005-2014).
• Administration of the PROMIS Pediatric Upper Extremity survey.
• Assessment of patient satisfaction and functional outcomes.

Main Results:

• Surgical excision yielded significantly higher patient satisfaction than ligation (P=0.003).
• No significant difference in esthetic satisfaction (P=0.07) or PROMIS hand function (P=0.765) between groups.
• 42% of patients treated with ligation required further surgery for complications like neuroma or persistent polydactyly.

Conclusions:

• Surgical excision leads to greater patient satisfaction for type B ulnar polydactyly.
• Ligation is associated with a higher failure rate and need for revision surgery.
• Counseling should incorporate these findings to guide treatment selection for parents.