Analysis of functional outcome after posttraumatic thumb reconstruction in comparison to nonreconstructed amputated thumbs at the proximal phalanx of the thumb ray: a mid-term follow-up with special attention to the Manchester-modified M2 DASH questionnaire and effect size of Cohen's d

The Journal of Trauma and Acute Care Surgery
Daryousch ParviziFranz Haas

Abstract

Pollicization, toe to thumb transfer, and osteoplastic thumb reconstruction, along with free tissue transfer, are the most reported reconstructive procedures after traumatic amputation at the proximal and middle third of the thumb. We will present our clinical studies on functional outcomes with special attention to the M2 DASH questionnaire and effect size of Cohen's d. Eleven patients (2 women and 9 men) with posttraumatic thumb reconstruction (three pollicizations of the index or index stump, four free lateral arm osteocutaneous neurosensory flaps, and four microvascular second toe to thumb transfers), performed during the period 2000 to 2007, were reexamined after 4.2 (SD ±2.1) years (range, 2-7 years postinjury). To ensure homogeneity among the patients' data, we selected only patients with isolated thumb amputations at the level of the proximal phalanx. The total M2-DASH score after thumb reconstruction was 18.55 (SD ±16.79). The M2-DASH score of patients with nonreconstructed thumbs was 32.77 (SD ±18.87). Pairwise comparisons between reconstructed and amputated thumbs showed statistically significant differences (Wilcoxon rank-sum test, p value = 0.03) and a highly effective improvement of hand function (Cohen's d = 1.10...Continue Reading

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Citations

Jan 8, 2016·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Tomoko KarubeHiroyuki Kato
Sep 18, 2014·The Journal of Hand Surgery·Heather BaltzerSteven J McCabe
Nov 18, 2018·Journal of Plastic Surgery and Hand Surgery·Akito NakanishiYasuhito Tanaka
Jul 15, 2015·Plastic and Reconstructive Surgery·Effrosyni KokkoliSeng-Feng Jeng

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