Parent Perspectives for Management of Ulnar Polydactyly
Gunnar Goebel, Scott Loewenstein MD, Joshua Adkinson MD
Indiana University School of Medicine
Presenter: Gunnar Goebel
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Joshua Adkinson
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Type-B ulnar polydactyly is one of the most commonly encountered congenital hand differences and can be treated with either suture ligation or surgical excision. The purpose of this study was to determine what factors families consider in selecting treatment for their child with type-B ulnar polydactyly.
We developed an ad-hoc survey instrument for parents of children with type-B ulnar polydactyly that assessed motivation for choosing treatment, parent-reported outcomes, and overall satisfaction. Differences between the cohorts were assessed using Chi square and Fischer exact tests for categorical variables and Student t-test for continuous variables.
Seventy of the 156 parents of consecutive patients contacted agreed to participate (45% response rate), with mean follow-up of 27 months. Twenty-eight chose in-office suture ligation; 42 chose surgical excision. Rapid treatment was prioritized more often in those who selected suture ligation than in those who opted for surgical excision (p=0.044). The complication rate for suture ligation was significantly higher than for surgical excision (p<0.0001), with the most common complication being a residual nubbin (64%). Respondents with residual bumps reported significantly less satisfaction with the aesthetic appearance of their child's hand (p<0.001) and with their child's treatment outcome (p=0.028) compared to those without residual bumps.
Factors considered by parents in choosing type of treatment for type-B ulnar polydactyly vary and may be significantly influenced by the surgeon. Time to treatment plays a determinative role in parents opting for suture ligation rather than surgical excision. Regardless of treatment, the majority of parents remain extremely satisfied with the outcomes.
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