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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Cosmetic appearance of congenital upper extremity anomalies

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  • presenting/speaker Noora Nietosvaara - New Children's Hospital, Helsinki, Finland
  • Antti Sommarhem - New Children's Hospital, Helsinki, Finland
  • Jani Puhakka - New Children's Hospital, Helsinki, Finland
  • Ruth Tan - National University Hospital, Singapore, Singapore
  • Johannes Schalamon - University Hospital Graz, Graz, Austria
  • Yrjänä Nietosvaara - New Children's Hospital, Helsinki, Finland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1691

doi: 10.3205/19ifssh0518, urn:nbn:de:0183-19ifssh05189

Published: February 6, 2020

© 2020 Nietosvaara et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Cosmetic disability of congenital hand anomalies is unknown. The purpose of this study was to determine the general opinion about how different congenitally malformed hands look.

Methods: We developed a questionnaire in a game format to evaluate the appearance of different hands. Altogether 1450 (954 females) 4-84-year-old residents (296 children) of two European and one Asian (n=102) country were asked to rate the appearance of hands on a 1-5 scale using emoticons. Standardized photographs of the dorsal aspect of 17 different congenitally malformed hands and a normal hand were presented to respondents. All 18 photographs were shown twice in a random order. For intrarater reliability ICC (A,1) and for interrater reliability ICC (C,1) estimates and their 95% CI were calculated. Significance of age, gender and nationality of the respondents was assessed using Mann-Whitney U test. Hands were divided into three subgroups according to the respondent's evaluations using Latent profile analysis.

Results and Conclusions: The normal hand and clinodactyly were perceived to have the best appearance. Symbrachydactyly and radial club hand received the lowest scores. Intrarater reliability was good (ICC=0.862, 95% CI 0.859-0.865, p<0,001) and interrater was moderate (ICC=0.621, 95% CI 0.479-0.786, p<0.001). Adults rated the appearance of all hands higher than children (p<0.05 in 14/18 hands), females regarded all hands better looking than men (p<0.05 in 15/18 hands) and Europeans gave higher scores (p<0.05 in 4/18) to all hands compared to Asians, with one exception. Europeans rated four-finger hand (mean=3.21, SD=1.18) better looking than six-finger hand (mean=2.92, SD=1.18), p<0.005), whereas Asians scored six-finger hand (mean=2.66, SD=1.26) higher than four-finger hand (mean=2.51, SD=1.14). The respondents' ranking order of the hands was consistent, except in the intermediate group (Table 1 [Tab. 1]).

Despite age, gender and nationality the appearance of different congenital upper limb anomalies is rated very similarly. Asians prefer an additional digit to a four-finger hand.