Purpose
To evaluate the implications of the transverse bone in cleft hand by assessing outcomes
after reconstruction in comparison with a control group.
Methods
This study is a retrospective review of 23 hands in 18 patients following surgical
reconstruction of the cleft hand. Eleven hands had a transverse bone component, and
12 hands (control group) did not. Patients and their families were contacted to assess
overall satisfaction following reconstruction. Clinical and radiographic records were
reviewed to assess aesthetic and functional outcomes, the need for additional surgery,
and radiographic divergence angles.
Results
There was no difference in aesthetic or functional subjective outcomes. There was
no statistically significant difference in any objective outcome measure between the
two groups. The use of the cleft for pinch was more dependent on the status of the
index finger and the preoperative thumb-index webspace rather than the presence of
a transverse bone. Eleven (4 transverse and 7 control) hands required additional surgery
to address abnormal function or posture of the index and ring fingers. Preoperative
radiographic divergence angles were larger in the transverse bone group than in the
control group, whereas postoperative divergence angles were nearly equivalent.
Conclusions
Similar outcomes between the two groups demonstrate that the presence of a transverse
bone in cleft hand was not associated with worse outcomes following cleft reconstruction.
Preoperative narrowing of the thumb webspace and postoperative index finger metacarpophalangeal
joint abnormality are associated with worse functional outcomes.
Type of study/level of evidence
Therapeutic Level III.
Key words
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Article info
Publication history
Published online: December 20, 2013
Accepted:
November 4,
2013
Received:
June 10,
2013
Footnotes
The authors would like to thank Jennifer Steffen for her helpful contribution to this manuscript.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
