Journal of Pediatric Orthopaedics - 2026-03-09 - Journal Article
Symbrachydactyly and Sports Participation.
Padilla AN, Tuberty S, Wren TAL, Tarrasch A, Lightdale-Miric NR
Topics
Key Takeaway
100% of children with symbrachydactyly reported sports participation, with 85.7% currently active, and injury incidence (34.3%) comparable to the general pediatric population, though greater limb deficiency was significantly associated with higher injury risk (P=0.03).
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Summary
This single-center cross-sectional survey assessed sports participation, injury rates, and perceived ability in children aged 6–18 with symbrachydactyly or congenital hand absence. All 35 participants reported lifetime sports participation; 80% denied disability-related limitation, and 34.3% sustained at least one sports-related injury. Level of deficiency did not predict participation but was significantly associated with injury incidence (P=0.03); PROMIS Upper Extremity median score was 35, below published norms, while PROMIS Peer Relationships median was 67, within normal range.
Key Limitation
The single-center sample of 35 patients from a tertiary referral center introduces selection bias that severely limits generalizability, and the cross-sectional design cannot establish whether deficiency level causally drives injury risk or whether confounding factors such as sport type or prosthetic use explain the association.
Original Abstract
BACKGROUND
While sports have demonstrated psychosocial and physical health benefits in children, there is little specific research regarding children with symbrachydactyly or congenital hand differences. The aim of this study is to assess sports participation, incidence of injury, and perceived abilities among children with symbrachydactyly, partial, or complete absence of a hand.
METHODS
In this single-center, cross-sectional survey study, patients between the ages of 6 and 18 years with a symbrachydactyly diagnosis were recruited at a pediatric tertiary hospital to complete a survey including questions regarding sport participation, injuries, and perceived inclusivity. In addition, participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity and Peer Relationships surveys and ABILHAND. These reported surveys and scores were compared with published norms for children in this age group.
RESULTS
Thirty-five participants (19 male and 16 female) with an average age of 11.4 years completed the study. Twenty-seven participants (77.1%) had one or more functioning digits on the affected arm, while 8 (22.9%) reported having no hand at the wrist or higher. All participants (100%) reported playing a sport at some point with 30 (85.7%) reporting that they still play this sport. The most reported sport was soccer with 10 participants (29.4%) answering that they play this sport predominantly. Twenty-eight participants (80.0%) answered "no" when asked if their disability limits participation in their sport. Twelve participants (34.3%) reported that they had sustained one or more injuries while playing their sport. Level of deficiency was not associated with sports participation; however, it was significantly associated with injury (P=0.03). Lastly, the median scores for the PROMIS Upper Extremity and PROMIS Peer Relationships were 35 and 67, respectively. The median score for the ABILHAND-Kids was 38.
CONCLUSION
All participants with symbrachydactyly participated in sports and most did not report that their disability limited their participation. The incidence of sports-related injury in these patients was similar to the incidence in the general pediatric population. Future directions would include collecting psychosocial outcome measures as well as increasing the sample size and geographic locations of the study.
LEVEL OF EVIDENCE
Level III-cross-sectional observational study.