Nina Lightdale-Miric1, Nicole M Mueske2, Emily L Lawrence3, Jennifer Loiselle4, Jamie Berggren4, Sudarshan Dayanidhi5, Milan Stevanovic2, Francisco J Valero-Cuevas6, Tishya A L Wren7. 1. Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA; Orthopaedic Surgery Department, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 2. Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA. 3. Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA. 4. Division of Rehabilitation Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. 5. Muscle Physiology Laboratory, Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA. 6. Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA. 7. Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA; Orthopaedic Surgery Department, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA. Electronic address: twren@chla.usc.edu.
Abstract
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.
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.
Authors: David T Netscher; Oluseyi Aliu; Brinkley K Sandvall; Kimberly G Staines; Kristy L Hamilton; Hector Salazar-Reyes; John Thornby Journal: J Hand Surg Am Date: 2013-01-04 Impact factor: 2.230
Authors: Jon R Davids; Laura C Peace; Lisa V Wagner; Mary Ann Gidewall; Dawn W Blackhurst; W Matthew Roberson Journal: J Bone Joint Surg Am Date: 2006-02 Impact factor: 5.284
Authors: Emily L Lawrence; Guilherme M Cesar; Martha R Bromfield; Richard Peterson; Francisco J Valero-Cuevas; Susan M Sigward Journal: Biomed Res Int Date: 2015-11-19 Impact factor: 3.411