title: Functional outcomes of children with index pollicizations for thumb deficiency.
abstract: OBJECTIVE
  To gain a comprehensive perspective on outcomes by performing an array of tests on patients who had undergone index pollicization for isolated thumb aplasia or severe hypoplasia in the absence of clinical radial dysplasia; this led us to create a graphical snapshot for future comparison. Another purpose was to compare the function of the contralateral hand and to compare parent and patient perspectives.
  
  
  METHODS
  We evaluated 22 hands (18 patients) by grip as well as lateral and tripod pinch strength tests; the pegboard Functional Dexterity Test (FDT); the Jebsen Hand Function Test (JHFT); and a parent/patient questionnaire. We compared operated hands with both contralateral nonoperated hands and nondominant hands in published normal data. We also compared contralateral nonoperated hands with dominant hands in published normal data, and FDT results and JHFT outcomes in children greater than 6 years old with published normal data. We evaluated questionnaire results.
  
  
  RESULTS
  Mean grip as well as lateral and tripod pinch strength in operated hands were 3.4, 1.2, and 1.2 kg, and in normal nondominant hands were 11.7, 4.4, and 3.9 kg, respectively. Patients' contralateral nonoperated hands were weaker than normal dominant hands. Mean timed FDT results in operated hands was 127 seconds, compared with 44 seconds in published normal data. In 2 of 5 JHFT subtests administered, no difference existed between operated hands and published normal data. A graphical snapshot took various outcome measures into consideration and showed a global assessment. Mean parent and patient questionnaire scores were 10 and 22, respectively (best = 12; worst = 60).
  
  
  CONCLUSIONS
  Comprehensive subjective and objective outcome testing suggested that an optimistic view of function after index pollicization is warranted. A graphical snapshot followed function over time. The contralateral hand fared worse than published normal data. Parent and patient perspectives were favorable.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopedic Surgery and Division of Plastic Surgery, Baylor College of Medicine, Houston, TX 77030, USA. netscher@bcm.edu
authors.forename: David T
authors.initials: DT
authors.lastname: Netscher
authors.forename: Oluseyi
authors.initials: O
authors.lastname: Aliu
authors.forename: Brinkley K
authors.initials: BK
authors.lastname: Sandvall
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Staines
authors.forename: Kristy L
authors.initials: KL
authors.lastname: Hamilton
authors.forename: Hector
authors.initials: H
authors.lastname: Salazar-Reyes
authors.forename: John
authors.initials: J
authors.lastname: Thornby
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000637:transplantation*; D005500:Follow-Up Studies; D006226:Hand Deformities / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D017060:Patient Satisfaction; D052581:Pinch Strength / Q000502:physiology*; D011183:Postoperative Complications / Q000503:physiopathology*; D012016:Reference Values; D013933:Thumb / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery