Lindley B Wall1, Aalok Patel2, Summer Roberts2, Charles A Goldfarb2. 1. Shriners Hospital for Children, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: wallli@wudosis.wustl.edu. 2. Shriners Hospital for Children, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.
Abstract
PURPOSE: This study was conducted to report the functional outcomes of the Huber opposition transfer (abductor digiti minimi muscle) in types II and IIIA hypoplastic thumbs. METHODS: Patients who had undergone a Huber opposition transfer with at least 5 years of follow-up were included in this study. There were 21 thumbs included; 12 returned for a detailed evaluation and 9 were included with a medical record review. Outcome measures included range of motion and pinch strength; Pediatric Outcomes Data Collection Instrument (PODCI) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected on those who could return. There were 15 type II and 6 type IIIA thumbs. RESULTS: Range of motion was significantly less than normal for both the interphalangeal and the metacarpophalangeal joints. For the returning cohort, key and tripod pinch were 44% and 65% of normal. The median Kapandji score was 9 (range, 6-10). The PODCI scores were high for global, upper extremity function, happiness, and pain. The PROMIS scores were similar to normal, except for parent reports of physical function. For all included patients, there was a revision surgery rate of 22%, primarily related to persistent instability. CONCLUSIONS: At a minimum 5-year follow-up, the Huber opposition transfer for types II and IIIA thumbs was shown to provide good subjective outcomes, despite limited range of motion and strength. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: This study was conducted to report the functional outcomes of the Huber opposition transfer (abductor digiti minimi muscle) in types II and IIIA hypoplastic thumbs. METHODS:Patients who had undergone a Huber opposition transfer with at least 5 years of follow-up were included in this study. There were 21 thumbs included; 12 returned for a detailed evaluation and 9 were included with a medical record review. Outcome measures included range of motion and pinch strength; Pediatric Outcomes Data Collection Instrument (PODCI) and Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected on those who could return. There were 15 type II and 6 type IIIA thumbs. RESULTS: Range of motion was significantly less than normal for both the interphalangeal and the metacarpophalangeal joints. For the returning cohort, key and tripod pinch were 44% and 65% of normal. The median Kapandji score was 9 (range, 6-10). The PODCI scores were high for global, upper extremity function, happiness, and pain. The PROMIS scores were similar to normal, except for parent reports of physical function. For all included patients, there was a revision surgery rate of 22%, primarily related to persistent instability. CONCLUSIONS: At a minimum 5-year follow-up, the Huber opposition transfer for types II and IIIA thumbs was shown to provide good subjective outcomes, despite limited range of motion and strength. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors: David Cella; Susan Yount; Nan Rothrock; Richard Gershon; Karon Cook; Bryce Reeve; Deborah Ader; James F Fries; Bonnie Bruce; Mattias Rose Journal: Med Care Date: 2007-05 Impact factor: 2.983
Authors: Eric C Makhni; Jason E Meldau; Jacob Blanchett; Peter Borowsky; Jeffrey Stephens; Stephanie Muh; Vasilios Moutzouros Journal: Orthop J Sports Med Date: 2019-06-24