Abstract：
OBJECTIVE: To assess the effect of radial longitudinal deficiency on the function of pollicized digits as determined by the Thumb Grasp and Pinch (T-GAP) assessment.
METHODS: We retrospectively evaluated 25 hands with thumb hypoplasia that underwent index finger pollicization. Patients were followed for an average of 10.4 years. Hands were divided by severity into two groups: no or mild radial longitudinal deficiency (RLD) (Group 1 = 16) and moderate to severe RLD (Group 2 = 9). We collected demographic information and completed physical examination measures, including hand strength, elbow, wrist, and hand range of motion, the Kapandji opposition score, active grasp span, and T-GAP total score.
RESULTS: Patients with moderate to severe forms of RLD had stiffer long fingers, lower Kapandji opposition scores, and limited active and passive range of motion for elbow flexion, wrist ulnar deviation, and pollicized thumb interphalangeal flexion. They had shorter forearms, decreased active grasp span, and fewer thumb creases at the interphalangeal thumb joint. In addition, the T-GAP total score was significantly lower when comparing the two groups. Children with mild dysplasia were able to achieve 32% of age-matched normal grasp strength. Patients with more severe radial dysplasia averaged 17% less grasp strength compared with children with mild dysplasia. Patients with moderate to severe RLD also had lower T-GAP total scores and strength measurements if they had limited wrist ulnar deviation.
CONCLUSIONS: Individuals with moderate to severe RLD have unique anatomical factors that affect outcomes after pollicization. These individuals use their thumbs for fewer activities, have weaker grasp, and retain more primitive grasp patterns compared with those who have milder forms of RLD.
METHODS: Prognostic IV.
METHODS: We retrospectively evaluated 25 hands with thumb hypoplasia that underwent index finger pollicization. Patients were followed for an average of 10.4 years. Hands were divided by severity into two groups: no or mild radial longitudinal deficiency (RLD) (Group 1 = 16) and moderate to severe RLD (Group 2 = 9). We collected demographic information and completed physical examination measures, including hand strength, elbow, wrist, and hand range of motion, the Kapandji opposition score, active grasp span, and T-GAP total score.
RESULTS: Patients with moderate to severe forms of RLD had stiffer long fingers, lower Kapandji opposition scores, and limited active and passive range of motion for elbow flexion, wrist ulnar deviation, and pollicized thumb interphalangeal flexion. They had shorter forearms, decreased active grasp span, and fewer thumb creases at the interphalangeal thumb joint. In addition, the T-GAP total score was significantly lower when comparing the two groups. Children with mild dysplasia were able to achieve 32% of age-matched normal grasp strength. Patients with more severe radial dysplasia averaged 17% less grasp strength compared with children with mild dysplasia. Patients with moderate to severe RLD also had lower T-GAP total scores and strength measurements if they had limited wrist ulnar deviation.
CONCLUSIONS: Individuals with moderate to severe RLD have unique anatomical factors that affect outcomes after pollicization. These individuals use their thumbs for fewer activities, have weaker grasp, and retain more primitive grasp patterns compared with those who have milder forms of RLD.
METHODS: Prognostic IV.
摘要：
目的：评估径向纵向缺陷对拇指手指功能的影响（T-GAP）评估。
方法：我们回顾性评估了25只拇指发育不全的手。患者平均随访10.4年。手按严重程度分为两组：无或轻度径向纵向缺陷（RLD）（第1组=16）和中度至重度RLD（第2组=9）。我们收集了人口统计信息并完成了体检措施，包括手部力量,弯头,手腕,和手部的运动范围，卡潘吉反对派得分，主动把握跨度，和T-GAP总分。
结果：患有中度至重度RLD的患者手指较硬，卡潘吉反对派得分较低，和有限的主动和被动活动范围的肘部屈曲，腕尺偏离,和拇指指间屈曲。他们的前臂较短，减少主动抓握跨度，指间拇指关节处的拇指折痕较少。此外,两组比较,T-GAP总分显著降低.轻度发育不良的儿童能够达到年龄匹配的正常抓握力量的32％。与轻度发育不良的儿童相比，患有更严重的放射状发育不良的患者平均抓握强度降低了17％。中度至重度RLD的患者如果腕部尺骨偏离有限，则T-GAP总分和强度测量值也较低。
结论：患有中度至重度RLD的个体具有独特的解剖学因素，这些因素会影响波兰后的结局。这些人用他们的拇指做更少的活动，掌握较弱，与具有较温和形式的RLD的人相比，保留了更原始的抓握模式。
方法：预后IV.
方法：我们回顾性评估了25只拇指发育不全的手。患者平均随访10.4年。手按严重程度分为两组：无或轻度径向纵向缺陷（RLD）（第1组=16）和中度至重度RLD（第2组=9）。我们收集了人口统计信息并完成了体检措施，包括手部力量,弯头,手腕,和手部的运动范围，卡潘吉反对派得分，主动把握跨度，和T-GAP总分。
结果：患有中度至重度RLD的患者手指较硬，卡潘吉反对派得分较低，和有限的主动和被动活动范围的肘部屈曲，腕尺偏离,和拇指指间屈曲。他们的前臂较短，减少主动抓握跨度，指间拇指关节处的拇指折痕较少。此外,两组比较,T-GAP总分显著降低.轻度发育不良的儿童能够达到年龄匹配的正常抓握力量的32％。与轻度发育不良的儿童相比，患有更严重的放射状发育不良的患者平均抓握强度降低了17％。中度至重度RLD的患者如果腕部尺骨偏离有限，则T-GAP总分和强度测量值也较低。
结论：患有中度至重度RLD的个体具有独特的解剖学因素，这些因素会影响波兰后的结局。这些人用他们的拇指做更少的活动，掌握较弱，与具有较温和形式的RLD的人相比，保留了更原始的抓握模式。
方法：预后IV.
