title: A clinically weighted approach to outcome assessment in radial polydactyly.
abstract: Currently available outcome assessment systems for radial polydactyly are mainly based on expert opinion. The aim of this study was to develop an outcome assessment system based on clinical data. We performed linear regression analysis on data from a multicentre study of 121 patients with radial polydactyly types II, IV and VII to develop a clinically weighted outcome assessment system. Items were weighted according to their influence on overall functional and aesthetic outcome in the regression analysis. Active flexion, scar appearance and prominence at amputation site were the main items influencing overall functional and aesthetic outcome (β = 0.393, β = 0.326 and β = 0.288, respectively). Palmar abduction, metacarpophalangeal joint deviation and nail appearance influenced overall functional and aesthetic outcome the least (β = -0.002, β = -0.104 and β = 0.070, respectively). Our proposed assessment system for radial polydactyly reflects the way clinicians value individual aspects of outcome as determinants of overall outcome and helps guide future treatment and evaluation of outcome.
  
  
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authors: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands r.dijkman@erasmusmc.nl.
authors: R
authors: R
authors: Dijkman
authors: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors: R
authors: R
authors: Selles
authors: Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors: J
authors: J
authors: van Rosmalen
authors: Department of Hand Surgery, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany.
authors: W
authors: W
authors: Hülsemann
authors: Department of Hand Surgery, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany.
authors: M
authors: M
authors: Mann
authors: Department of Hand Surgery, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany.
authors: R
authors: R
authors: Habenicht
authors: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors: S
authors: S
authors: Hovius
authors: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
authors: C
authors: C
authors: van Nieuwenhoven
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005384:Finger Joint; D006801:Humans; D016014:Linear Models; D008297:Male; D008662:Metacarpophalangeal Joint; D017063:Outcome Assessment, Health Care; D017689:Polydactyly / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D055815:Young Adult
keywords: Congenital hand; outcome assessment; radial polydactyly; results; surgery