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Patient-Rated Outcomes after Toe Syndactyly Reconstruction

Adkinson, Joshua MD Gross, Jeffrey, MD Singh, Nikhi, MD, MBA Harmon, Cameron
Indiana University School of Medicine
2023-01-31

Presenter: Singh, Nikhi

Affidavit:
JA

Director Name: Adkinson, Joshua

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction

Introduction:
Toe syndactyly has an incidence of approximately 1/2000 live births and may lead to psychological distress for the parents or caregivers. Currently there are no prospective reviews of outcomes after toe syndactyly reconstruction. In this study, we sought to evaluate patient/parent-reported outcomes (PROs) after toe syndactyly reconstruction to improve shared decision-making.

Methods:
A retrospective review of patients was performed. Inclusion criteria were patients under 18 years-old at Riley Children's Hospital who underwent congenital toe syndactyly reconstruction between 2019 and 2022. Five subjects completed surveys regarding pain, social interactions, depression, and ability to perform physical activity. Scores were aggregated by category and normalized to a scale of 0-1. Scores closer to 1 indicate more of the item assessed (e.g., pain, social issues, depressive symptoms, or physical disability).

Results:
24 patients underwent congenital toe syndactyly release between 2019 and 2022. Average patient age was 2.33 years at time of surgery. Pain scores averaged 0.35 +/- 0.10. Social interaction scores averaged 0.18 +/- 0.06. Depression scores averaged 0.16 +/- 0.06. Physical activity/ability scores averaged 0.09 +/- 0.06.

Conclusion:
Congenital toe syndactyly may cause significant stress for the parents/caregivers, given concerns regarding functional compromise and cosmesis. In this study, we found that patients had intermittent pain, but positive social interaction (parents indicated that many social issues were related to patient age, rather than from the procedure). Results also indicated minimal depression and impacts on physical activity. These data can be used as a resource for decision-making when considering toe syndactyly reconstruction for children.

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