Plastic and Reconstructive Surgery, Global Open (Jan 2024)

A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision

  • Nakul Ganju, BS,
  • Esperanza Mantilla-Rivas, MD,
  • Paul F. Martinez, BS,
  • Monica Manrique, MD,
  • Joseph M. Escandón, MD,
  • Samay Shah, BS,
  • Ashley E. Rogers, MD,
  • Michael J. Boyajian, MD,
  • Albert K. Oh, MD,
  • Gary F. Rogers, MD, JD, LLM, MBA, MPH

DOI
https://doi.org/10.1097/GOX.0000000000005557
Journal volume & issue
Vol. 12, no. 1
p. e5557

Abstract

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Background:. Interventions for type B postaxial polydactyly include suture ligation and surgical excision, yet there is a paucity of literature comparing the outcomes of these procedures. This study sought to compare patient-reported long-term outcomes of postaxial digit excision. Methods:. A six-question survey was distributed from January 2021 to March 2022 to patients who underwent treatment for type B postaxial polydactyly at a single pediatric institution from 2010 to 2016. Patients were queried about the incidence of pain sensitivity, keloid healing, and/or persistent presence of bump (“nubbin”) at the treatment site. Results:. A total of 158 responses accounting for 258 digits were attained for a 53% response rate. The majority of digits (67.4%, n = 174) were surgically excised. Median age at procedure was 49 days: 13.0 days for ligation, 63.0 days for surgical excision. Median age at survey was 8 [IQR 5.4–10.2] years. Short-term (<30 days after procedure) complications rate was 1.6%. The rate of a raised or sensitive scar was 39.5% (ligation 51.5% versus surgery 35.4%, P < 0.05). The likelihood of postoperative sensitivity (P = 0.80) was similar among groups. However, the odds of a residual bump or raised scar at the surgical site was significantly higher in the ligation group (P = 0.001). These findings remained significant in the adjusted analysis. Conclusion:. This study suggests that suture ligation can be used in select cases without increasing the prevalence of long-term pain or sensitivity, albeit with greater risk of a bump or raised scar at the excision site compared with surgical excision.