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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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Outcome in radial polydactyly at the interphalangeal and metacarpophalangeal level: An international multicenter study

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  • presenting/speaker Robert Dijkman - Erasmus MC, Rotterdam, Netherlands
  • Ruud Selles - Erasmus MC, Rotterdam, Netherlands
  • Wiebke Hülsemann - Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
  • Max Mann - Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
  • Rolf Habenicht - Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
  • Steven Hovius - Erasmus MC, Rotterdam, Netherlands
  • Christianne Van Nieuwenhoven - Erasmus MC, Rotterdam, Netherlands

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. DocIFSSH19-1274

doi: 10.3205/19ifssh1370, urn:nbn:de:0183-19ifssh13702

Published: February 6, 2020

© 2020 Dijkman 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: The aim of this international multicenter study was to investigate how patient characteristics and surgical technique influence outcome in radial polydactyly.

Methods: Patients with radial polydactyly types II, IV and IV with triphalangism ('IV-Tph') were evaluated using the validated Rotterdam outcome assessment system. Multiple determinants of outcome were studied, including polydactyly type, number of surgeries, age at operation, nail presentation, clinical deviation, tendon anomalies, surgical technique and surgeon experience.

Results and Conclusions: Of the 114 cases in this study, 94 (82%) were evaluated after single surgery with a mean follow-up of 7.8 years, and 20 (18%) cases were evaluated after multiple surgeries with a mean follow-up of 11.5 years. There were no significant differences in overall outcome between the specific types of radial polydactyly. Within the single surgery group, functional domain outcome was worse for type IV (1.3 points; p=0.005) compared to types II and IV-Tph. The multiple surgeries group had worse overall outcome (4.2 points; p<0.001), functional outcome (1.4 points; p=0.010), pain (1.1 points; p<0.001) and satisfaction (0.7 points; p=0.012) compared to the single surgery group. Tendon anomalies were more frequently treated in the worst outcomes. Overall outcome was better in patients primarily treated by dedicated congenital hand surgeons (2.7 points; p=0.014) compared to less specialized consultants.

The most common types of radial polydactyly have similar overall outcome. However, a number of item- and domain-specific outcomes of type IV are worse. This indicates treatment of type IV remains challenging, especially in cases with tendon abnormalities, which are likely to influence outcome in a negative way. Our results suggest treatment of radial polydactyly by dedicated congenital hand surgeons is associated with better outcomes.