Long term functional outcomes after early childhood pollicization.
J Hand Ther. 2014 Dec 4;
Authors: Lightdale-Miric N, Mueske NM, Lawrence EL, Loiselle J, Berggren J, Dayanidhi S, Stevanovic M, Valero-Cuevas FJ, Wren TA
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.
PMID: 25835252 [PubMed – as supplied by publisher]
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