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Parent-Reported Outcomes Following Type B Ulnar Polydactyly Excision in the Clinic Versus the Operating Room:
Joshua D. Gerstein1, Khoa Tran2, Nikhi P. Singh M.D.3, Gregory H. Borschel M.D.4, Joshua M. Adkinson M.D.5, 1Indiana University School of Medicine; 2-5Indiana University School of Medicine, Department of Surgery, Division of Plastic Surgery
Indiana University School of Medicine
2025-01-10
Presenter: Joshua Gerstein
Affidavit:
n/a
Director Name: Joshua Adkinson
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Background:
Ulnar polydactyly, the presence of an extra finger on the post-axial hand, is a common congenital abnormality causing functional and aesthetic impairments. Treatment typically involves surgical excision in an office or operating room (OR). This study compares outcomes for type B ulnar polydactyly surgery performed in the OR versus office.
Methods:
We evaluated treatment outcomes and parental satisfaction via a telephone or email survey using REDCap for children treated at Riley Children's Hospital (2020–2024). Satisfaction was measured on a 1 to 10 visual analog scale (VAS); 1 equating to minimum satisfaction, 10 equating to maximum satisfaction.
Results:
Of 159 parents, 28 participated-13 elected for OR excision and 15 opting for office procedures. No significant differences were found between groups regarding race, education, or marital status. Families with a history of polydactyly selected OR excision more frequently (61.5%) than families without such history (33.3%). VAS scores for comfort, functional outcomes, and appearance satisfaction showed no significant differences between groups or when stratified by family history. There were no significant differences in satisfaction between excision in the office or OR.
Conclusions:
Office-based excision faces challenging logistics-sufficient lighting, staffing, and cooperation from parents and children. Parents who choose surgical excision in the office are satisfied with the treatment outcomes, would not change any of their treatment decisions, and would recommend their treatment process to others. While challenges exist, excision in the office may result in lower healthcare costs while providing similar outcomes.
