Format

Send to

Choose Destination
See comment in PubMed Commons below
J Hand Surg Am. 2008 Nov;33(9):1579-88. doi: 10.1016/j.jhsa.2008.05.010.

Central ray deficiency: subjective and objective outcome of cleft reconstruction.

Author information

1
Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes Jewish Hospitals, St. Louis, MO, USA. goldfarbc@wudosis.wustl.edu

Abstract

PURPOSE:

To assess the long-term subjective and objective outcome of cleft reconstruction in patients with central ray deficiency.

METHODS:

Twelve patients with 16 central ray deficiency hands were included. Each hand had been treated with cleft reconstruction using soft tissue and/or bony procedures. A surgeon and parent assessed the subjective outcome using a visual analog scale to compare preoperative and postoperative appearance. Objective outcome was assessed with a clinical examination for digital range of motion and with a radiographic examination for preoperative and postoperative divergence angles of the index finger and ring finger metacarpals and phalanges.

RESULTS:

The surgeon's visual analog scale score significantly increased from 4 to 7. Nine parents were very satisfied, 4 were satisfied, and 3 were somewhat satisfied with hand appearance. A ring finger proximal interphalangeal joint flexion contracture averaging 31 degrees was the most notable clinical finding. The metacarpal divergence angle significantly improved from 33 degrees to 12 degrees , and the phalangeal divergence angle significantly improved from 38 degrees to 12 degrees .

CONCLUSIONS:

Cleft reconstruction improves hand appearance in patients with central deficiency. A new technique of quantifying the radiographic divergence of the border rays of the cleft demonstrates improved alignment at long-term follow-up.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

PMID:
18984341
DOI:
10.1016/j.jhsa.2008.05.010
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center