Primary treatment of type B post-axial ulnar polydactyly: A systematic review and meta-analysis. (December 2022)

• Record Type: Journal Article
• Authors: Samarendra, Harsh; Wade, Ryckie G.; Glanvill, Louise; Wormald, Justin; Jain, Abhilash
• Is Part Of: JPRAS open. Volume 34(2022)
• Page Start: 21
• Page End: 33
• Publication Date: 2022-12
• Subjects: Ulnar polydactyly -- Adverse events -- Patient-reported outcomes -- Surgical outcomes -- Excision ligation; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.jpra.2022.05.002
• Languages: English
• ISSNs: 2352-5878

Abstract

Abstract: Optimal management of pedunculated ulnar polydactyly is not defined. This systematic review summarises objective and patient-reported outcomes following primary treatment. Two authors screened articles for inclusion according to a PROSPERO published protocol. The meta-analysis of adverse events was performed, and a narrative synthesis of satisfaction and patient-reported outcomes was reported. The risk of bias was assessed using Cochrane's ROBINS-I tool. Of 1650 articles identified, 15 were eligible, including 13 single-arm and 2 multi-arm studies. Complications were 6 times as likely with ligation procedures (22%), compared to surgical removal (1%) whether this was performed in the outpatient setting or operating theatre (OR 6.89 [95% CI 1.73, 27]). Parent-reported satisfaction was high for all treatments. Studies were at high risk of bias and low methodological quality. Outcome measurement and follow-up were heterogenous. Well-designed prospective observational and experimental studies are required to inform practice, incorporating clinician and parent-reported outcomes and economic analyses. Level of evidence: I.