title: Congenital thumb anomalies and the consequences for daily life: patients' long-term experience after corrective surgery. A qualitative study.
abstract: OBJECTIVE
  The aim of the study was to explore patients' long-term experience of a congenital hand problem, and the consequences for daily life.
  
  
  METHODS
  Fifteen participants with a median age 24 years (17-55 years), born with thumb hypoplasia/aplasia or thumb duplication were interviewed using a semi-structured interview guide. The interviews were subjected to qualitative content analysis.
  
  
  RESULTS
  Although the mobility and strength in the thumb/hand(s) varied within the group, hand function was generally described as good. Compensatory strategies were used to overcome practical obstacles. The emotional reactions to being visibly different from peers in early life varied from total acceptance and a sense of pride in being special, to deep distress and social withdrawal. Support from parents, teachers and others was important in facing emotional challenges and practical consequences.
  
  
  CONCLUSIONS
  The present study highlights the importance of healthcare professionals addressing appearance-related concerns which may have long-term emotional and social consequences for patients born with a thumb anomaly. Implications for Rehabilitation Appearance-related concerns and need for emotional support should be fully considered throughout the rehabilitation process to prevent distress and social withdrawal. Effective problem-solving strategies, such as compensation, change in occupational performance and support from others may reduce activity limitations and participation restriction.
authors.affiliation: a Department of Translational Medicine - Hand Surgery , Skane University Hospital, Lund University , Sweden.
authors.forename: I K
authors.identifier: http://orcid.org/0000-0002-2746-8346
authors.initials: IK
authors.lastname: Carlsson
authors.affiliation: a Department of Translational Medicine - Hand Surgery , Skane University Hospital, Lund University , Sweden.
authors.forename: L B
authors.identifier: http://orcid.org/0000-0003-1334-3099
authors.initials: LB
authors.lastname: Dahlin
authors.affiliation: a Department of Translational Medicine - Hand Surgery , Skane University Hospital, Lund University , Sweden.
authors.forename: H-E
authors.identifier: http://orcid.org/0000-0001-9229-2319
authors.initials: HE
authors.lastname: Rosberg
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006226:Hand Deformities / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D000069451:Long Term Adverse Effects / Q000209:etiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000523:psychology; D036301:Qualitative Research; D012919:Social Behavior; D013548:Sweden; D013933:Thumb / Q000002:abnormalities* / Q000601:surgery
keywords: Thumb hypoplasia/aplasia; adaptation; hand disfigurement; pollicisation; qualitative research; thumb duplication