Clinic-based Treatment of Type B Ulnar Polydactyly Saves Costs Compared With Treatment in the Operating Room

Background: One in 500 children in the United States is born with polydactyly. Type B ulnar polydactyly excision is often performed in the operating room (OR) but can also be conducted in an office setting. This study compares costs for patients/families and healthcare systems between these settings. Methods: A retrospective review from January 2019 to December 2023 included patients who underwent type B ulnar polydactyly excision. Patients were categorized into in-office or OR groups. Patient demographics and financial data were analyzed using independent-samples t tests, χ 2 tests, and analysis of variance (significance: P < 0.05). Results: Of 114 patients, 64 underwent in-office excision and 50 underwent OR excision. Total charges to the payer were significantly lower for in-office excision compared with OR ($2130 versus $10,731; P < 0.001). The average cost per digit removed was also less for in-office procedures ($1218 versus $5937; P < 0.001). Health system costs were lower for in-office excision overall ($845 versus $2349; P < 0.001) and per digit ($472 versus $1272; P < 0.001). Conclusions: In-office excision of type B ulnar polydactyly significantly reduces costs for patients, families, and healthcare systems. Shifting care to the office can alleviate OR demand and decrease financial burdens. These cost differences should inform care planning and resource allocation.