Correlation and Optimal Cutoff Value of the Japanese Society for Surgery of the Hand Score for Postoperative Satisfaction in Radial Polydactyly: A Retrospective Cohort Study.

Abstract

The purpose of this study was to assess the correlation between the Japanese Society for Surgery of the Hand (JSSH) score and parental satisfaction in patients with radial polydactyly and to identify the optimal JSSH score that correlates with parental satisfaction. A retrospective study was conducted on 144 patients (144 thumbs) who underwent surgery for radial polydactyly between October 2017 and September 2023. Patients were classified according to the modified Wassel-Flatt classification, excluding hypoplastic types. Postoperative outcomes were evaluated using the JSSH scoring system, totaling 20 points distributed across functional, appearance, and subjective parameters. Parental satisfaction regarding function and appearance was assessed using a five-point Likert scale. Spearman's rank correlation assessed the relationship between the JSSH score and parental satisfaction, and receiver operating characteristic curve analysis was used to determine the optimal cutoff value of the JSSH score corresponding to parental satisfaction. The JSSH score demonstrated a significant correlation with overall parental satisfaction. The optimal cutoff value for predicting parental satisfaction was determined to be 18.5, with an area under the receiver operating characteristic curve of 0.82. The effect size between satisfied and unsatisfied parents was 1.26. Parents reported significantly lower satisfaction with appearance outcomes compared with functional outcomes. Notably, the appearance parameter of the JSSH score showed a weak correlation with appearance satisfaction, along with limited discriminative ability and a small effect size. We noted a significant correlation between JSSH score and parental satisfaction in patients with radial polydactyly and established an optimal cutoff value of 18.5 points. Future development of a scoring system that better integrates both functional and aesthetic considerations (social function) could enhance the evaluation and management of patients with polydactyly.