title: Developing a pollicization outcomes measure.
abstract: OBJECTIVE
  To evaluate which objective criteria correlated with subjective impressions of outcome following index finger pollicization for thumb hypoplasia.
  
  
  METHODS
  Forty-two pollicizations in 35 patients were assessed by a comprehensive subjective and objective measurement analysis. In the subjective measures, the surgeon, therapist, and caregiver rated how the pollicized digit "looks like a thumb" and "works like a thumb." The caregiver also completed a subjective questionnaire. For objective results, we measured appearance, strength, range of motion, stability, and ability to pick up objects. The subjective results were then correlated with objective data via a linear regression analysis.
  
  
  RESULTS
  When combining the total subjective score for "looks like a thumb," "works like a thumb," and the caregiver questionnaire, we found significant correlation scores for palmar abduction, lateral pinch, tip pinch, and picking up a bead, a die, and a table tennis ball. The strongest correlations were found with composite flexion, metacarpophalangeal (MCP) joint range of motion, interphalangeal (IP) joint range of motion, and the sticker test. Three of these 4 items (sticker test and MCP joint and IP arcs of motion) also correlated best with children who preferred using their thumbs for small object acquisition instead of scissor pinch.
  
  
  CONCLUSIONS
  Composite flexion, MCP and IP joint arcs of motion, and the sticker test correlated the strongest with the subjective criteria. These parameters appear to be the most critical measures that impress a good outcome following pollicization.
  
  
  METHODS
  Prognostic IV.
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA; Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA; University of Maryland Medical Center, Baltimore, MD. Electronic address: dzlotolow@yahoo.com.
authors.forename: Dan A
authors.initials: DA
authors.lastname: Zlotolow
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA; Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA; University of Maryland Medical Center, Baltimore, MD.
authors.forename: Rick
authors.initials: R
authors.lastname: Tosti
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA; Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA; University of Maryland Medical Center, Baltimore, MD.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ashworth
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA; Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA; University of Maryland Medical Center, Baltimore, MD.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kozin
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA; Department of Orthopaedic Surgery and Sports Medicine, Temple University School of Medicine, Philadelphia, PA; University of Maryland Medical Center, Baltimore, MD.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Abzug
mesh_terms: D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D005385:Fingers / Q000637:transplantation*; D018737:Hand Strength; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013933:Thumb / Q000002:abnormalities* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Outcome; pollicization; thumb hypoplasia