Quality of life in children with preaxial polydactyly of the foot in comparison to adults, postaxial polydactyly and healthy controls.

Abstract

The effect of preaxial polydactyly of the foot on health-related quality of life (HR-QoL) has not been investigated in current literature. To improve counseling, we investigated HR-QoL in this patient group. A patient-control study was performed with children with preaxial polydactyly ( n = 20), adults with preaxial polydactyly ( n = 15), children with postaxial polydactyly ( n = 15) and healthy controls ( n = 62). The primary outcome was the difference in the foot-specific quality of life (FS-QoL) between children with preaxial polydactyly and adults with preaxial polydactyly, children with postaxial polydactyly and controls, using the Oxford Ankle and Foot Questionnaire (OxAFQ-c) and five foot-specific visual analogue scales (VAS). The secondary outcome was the difference in general HR-QoL, using the Pediatric Quality of Life Inventory (PedsQL). Outcomes were compared with the Mann-Whitney-U test. Comparison between children with preaxial polydactyly and healthy controls and postaxial polydactyly showed worse outcomes in all OxAFQ-c domains. The foot-specific VAS score was significantly worse in children with preaxial polydactyly compared to postaxial polydactyly and controls. Only the PedsQL physical domain showed a lower outcome in children with preaxial polydactyly than in postaxial polydactyly and controls. Children and adults with preaxial polydactyly scored the same in all domains. The OxAFQ-c and the PedsQL physical domain showed significantly worse outcomes in children with preaxial polydactyly compared with healthy controls and postaxial polydactyly. However, large variation was observed, suggesting large differences between patients. In children and adults, the foot and scar appearance seems to be the biggest problem, while diminished foot function seems less of an issue.