Medical Student Research Fellowship for Summer 2010
Mentor: Marybeth Ezaki
Department: Director of Hand Surgery, Texas Scottish Rite Hospital for Children; Professor of Orthopedic Surgery, UTSW Medical School
Address: Texas Scottish Rite Hospital for Children
2222 Welborn Street, Dallas, TX75219
Phone number: 214-559-7842
Project title: Outcomes in Thumb Reconstruction for Radial Polydactyly
Human subjects IRB approved project number (where applicable):
IRB #: 012010-056
Project Type: Patient based
Brief Description of Project:
Purpose: To show that Tada scores are not reliable predictors of outcome based on quality of life measurements for patients who have had thumb reconstruction for radial polydactyly.
Background: The evaluation of thumb reconstruction for radial polydactyly has largely been based on a classification system published by Tada in JBJS in 1983. The Tada post-op scoring system breaks down outcomes into good, fair, and poor by assigning a number based on the patient's degree of range of motion, instability of the thumb, and degree of malalignment. (The lower the score, the worse the outcome) (JBJS 1983) The Wassell classification system of type of polydactyly along with the Tada scoring system for post-op evaluation of the thumb is widely used to predict outcomes for these children. Very few outcome studies have been published that examine the relationship between function, quality of life, and residual radial angulation, instability and joint stiffness. This indicates the need for a study using the comparatively large number of patients at TSRH that could see if the Tada score is truly predictive of outcomes.
Concise Summary of Project: Patients who are between the ages of 1 and 18 who have had reconstruction for radial polydactyly will be identified by a review of medical records. Using medical records, we will record their Tada score, post-operative angulation, instability, and joint stiffness. These patients will be contacted prospectively by mail and by phone and invited to participate in a one-time survey using the Pediatric Quality of Life questionnaire. They could be asked to return for a clinical evaluation which would take about 30 minutes if 1) a Tada score was not assigned post-op or 2) there is not enough information in the medical chart to assign a Tada score. We anticipate including 350 subjects in this project which will require 2 years for data collection. Analysis of the data and reporting the findings may take another 12 months for a total of 3 years.
Previous Research Activities or Publications with Medical Students:
Medical students with other programs have participated in summer research doing background literature research on vascular anatomy of the growth plates of the digits; immunofluorescent staining of cultured cells looking for upregulation of pathways in macrodactyly. Manuscripts in preparation at this time.