BMC Musculoskeletal Disorders | |
Hand function in children with radial longitudinal deficiency | |
Marianne Arner3  Michael Werner2  Monica Wiig4  Hans-Eric Rosberg1  Lars B Dahlin1  Anna Gerber Ekblom3  | |
[1] Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden;Department of Radiology, Södersjukhuset, Stockholm, Sweden;Department of Hand Surgery, Södersjukhuset, Stockholm, Sweden;Department of Hand Surgery, Uppsala University Hospital, Uppsala, Sweden | |
关键词: CHEQ; AHA; ICF-CY; Functional outcome; Children; Hand function; Radial club hand; Radial aplasia; Aplasia of the radius; Radial longitudinal deficiency; | |
Others : 1133191 DOI : 10.1186/1471-2474-14-116 |
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received in 2012-05-15, accepted in 2013-03-19, 发布年份 2013 | |
【 摘 要 】
Background
In children with hypoplasia or aplasia of the radius (radial longitudinal deficiency) manual activity limitations may be caused by several factors; a short and bowed forearm, radial deviation of the wrist, a non-functional or absent thumb, limited range of motion in the fingers and impaired grip strength. The present study investigates the relation between these variables and activity and participation in children with radial dysplasia.
Methods
Twenty children, age 4–17 years, with radial longitudinal dysplasia Bayne type II-IV were examined with focus on the International Classification of Functioning and Health, version for Children and Youth (ICF-CY) context. Body function/structure was evaluated by measures of range of motion, grip strength, sensibility and radiographic parameters. Activity was examined by Box and Block Test and Assisting Hand Assessment (AHA). Participation was assessed by Children’s Hand-use Experience Questionnaire (CHEQ). Statistical correlations between assessments of body function/structure and activity as well as participation were examined.
Results
The mean total active motion of wrist (49.6°) and digits (447°) were less than norms. The mean hand forearm angle was 34° radially. Ulnar length ranged from 40 to 80% of age-related norms. Grip strength (mean 2.7 kg) and Box and Block Test (mean 33.8 blocks/minute) were considerably lower than for age-related norms. The mean score for the AHA was 55.9 and for CHEQ Grasp efficiency 69.3. The AHA had significant relationship with the total range of motion of digits (p = 0.042). Self-experienced time of performance (CHEQ Time) had significant relationship with total active motion of wrist (p = 0.043). Hand forearm angle did not show any significant relationship with Box and Block Test, AHA or CHEQ.
Conclusion
In radial longitudinal deficiency total range of motion of digits and wrist may be of more cardinal importance to the child’s activity and participation than the angulation of the wrist.
【 授权许可】
2013 Gerber Ekblom et al.; licensee BioMed Central Ltd.
【 预 览 】
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Figure 1. | 79KB | Image | download |
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【 参考文献 】
- [1]Birch-Jensen A: Incidence of Deformities of Abscence. Edited by Birch-Jensen A. Andelsbogtryckeriet in Odense and Det Danske Forlag: Congenital Deformities of the Upper Extremities Copenhagen; 1949:11-14.
- [2]Bod M, Czeizel A, Lenz W: Incidence at birth of different types of limb reduction abnormalities in Hungary 1975–1977. Hum Genet 1983, 65(1):27-33.
- [3]Froster-Iskenius UG, Baird PA: Limb reduction defects in over one million consecutive livebirths. Teratology 1989 Feb, 39(2):127-135.
- [4]Ekblom AG, Laurell T, Arner M: Epidemiology of congenital upper limb anomalies in 562 children born in 1997 to 2007: a total population study from stockholm, sweden. J Hand Surg Am 2010, 35(11):1742-1754.
- [5]Lamb DW: Radial club hand. A continuing study of sixty-eight patients with one hundred and seventeen club hands. J Bone Joint Surg Am 1977, 59(1):1-13.
- [6]Bayne LG, Klug MS: Long-term review of the surgical treatment of radial deficiencies. J Hand Surg Am 1987, 12(2):169-179.
- [7]Kallen K, Mastroiacovo P, Castilla EE, Robert E, Kallen B: VATER non-random association of congenital malformations: study based on data from four malformation registers. Am J Med Genet 2001 Jun 1, 101(1):26-32.
- [8]Cox H, Viljoen D, Versfeld G, Beighton P: Radial ray defects and associated anomalies. Clin Genet 1989 May, 35(5):322-330.
- [9]Goldfarb CA, Wall L, Manske PR: Radial longitudinal deficiency: the incidence of associated medical and musculoskeletal conditions. J Hand Surg Am 2006, 31(7):1176-1182.
- [10]Stoll C, Alembik Y, Dott B, Roth MP: Associated malformations in patients with limb reduction deficiencies. Eur J Med Genet 2010, 53(5):286-290.
- [11]Bora FW Jr, Osterman AL, Kaneda RR, Esterhai J: Radial club-hand deformity. Long-term follow-up. J Bone Joint Surg Am 1981, 63(5):741-745.
- [12]Geck MJ, Dorey F, Lawrence JF, Johnson MK: Congenital radius deficiency: radiographic outcome and survivorship analysis. J Hand Surg Am 1999, 24(6):1132-1144.
- [13]Sestero AM, Van Heest A, Agel J: Ulnar growth patterns in radial longitudinal deficiency. J Hand Surg Am 2006, 31(6):960-967.
- [14]Damore E, Kozin SH, Thoder JJ, Porter S: The recurrence of deformity after surgical centralization for radial clubhand. J Hand Surg Am 2000, 25(4):745-751.
- [15]Dana C, Auregan JC, Salon A, Guero S, Glorion C, Pannier S: Recurrence of radial bowing after soft tissue distraction and subsequent radialization for radial longitudinal deficiency. J Hand Surg Am 2012, 37(10):2082-2087.
- [16]Buck-Gramcko D: Radialization as a new treatment for radial club hand. J Hand Surg Am 1985, 10(6):964-968.
- [17]Goldfarb CA, Klepps SJ, Dailey LA, Manske PR: Functional outcome after centralization for radius dysplasia. J Hand Surg Am 2002, 27(1):118-124.
- [18]Buffart LM, Roebroeck ME, Janssen WG, Hoekstra A, Selles RW, Hovius SE: Hand function and activity performance of children with longitudinal radial deficiency. J Bone Joint Surg Am 2008, 90(11):2408-2415.
- [19]Holtslag I, Wijk IV, Hartog H, van der Molen AM, van der Sluis C: Long-term functional outcome of patients with longitudinal radial deficiency: cross-sectional evaluation of function, activity and participation. Disabil Rehabil 2012. (EPub ahead of print) PMID 23167292. AID-10.3109/09638288.2012.737086 (doi)
- [20]James MA, McCarroll HR Jr, Manske PR: The spectrum of radial longitudinal deficiency: a modified classification. J Hand Surg Am 1999, 24(6):1145-1155.
- [21]Vilkki SK: Distraction and microvascular epiphysis transfer for radial club hand. J Hand Surg Br 1998, 23(4):445-452.
- [22]Moberg E: Two-point discrimination test. A valuable part of hand surgical rehabilitation, e.g. in tetraplegia. Scand J Rehabil Med 1990, 22(3):127-134.
- [23]Rosen B, Lundborg G: A new tactile gnosis instrument in sensibility testing. J Hand Ther 1998, 11(4):251-257.
- [24]Bell J: Semmes-Weinstein Monofilament Test for Determining Cutaneous Light Touch/Deep Pressure Sensation. The Star 1984, 44:8-11. 16
- [25]Manske PR, McCarroll HR Jr, Swanson K: Centralization of the radial club hand: an ulnar surgical approach. J Hand Surg Am 1981, 6(5):423-433.
- [26]Maresh MM: Linear growth of long bones of extremities from infancy through adolescence; continuing studies. AMA Am J Dis Child 1955 Jun, 89(6):725-742.
- [27]Mathiowetz V, Federman SM, Wiemer DM: Box and Blocks Test of Manual dexterity: Norms for 6–19 Year Olds. Can J Occup Ther 1985, 52(5):241-245.
- [28]Krumlinde-Sundholm L: Development of the Assissting Hand Assessment: a Rasch-built measure intended for children with unilateral upper limb impairments. Scan J Occup Ther 2003, 10:16-26.
- [29]Krumlinde-Sundholm L, Holmefur M, Kottorp A, Eliasson AC: The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change. Dev Med Child Neurol 2007 Apr, 49(4):259-264.
- [30]Skold A, Hermansson LN, Krumlinde-Sundholm L, Eliasson AC: Development and evidence of validity for the Children’s Hand-use Experience Questionnaire (CHEQ). Dev Med Child Neurol 2011 May, 53(5):436-442.
- [31]Velozo CA, Kielhofner G, Lai JS: The use of Rasch analysis to produce scale-free measurement of functional ability. Am J Occup Ther 1999, 53(1):83-90.
- [32]Haley SM: Coster, Wendy J., Ludlow, Larry H., Haltiwanger, Jane, Andrellos, Peter, editor. Pediatric Evaluation of Disability Inventory (PEDI). 1.0. Boston: New England Medical Center Hospitals, PEDI Research Group; 1992.
- [33]Nordmark E, Orban K, Hagglund G, Jarnlo GB: The American Paediatric Evaluation of Disability Inventory (PEDI). Applicability of PEDI in Sweden for children aged 2.0-6.9 years. Scand J Rehabil Med 1999 Jun, 31(2):95-100.
- [34]Beaton DE, Wright JG, Katz JN: Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005, 87(5):1038-1046.
- [35]Werner B, Bodin L: Growth from birth to age 19 for children in Sweden born in 1981: descriptive values. Acta Paediatr 2006 May, 95(5):600-613.
- [36]Watson HK, Beebe RD, Cruz NI: A centralization procedure for radial clubhand. J Hand Surg Am 1984, 9(4):541-547.
- [37]Mathiowetz V, Wiemer DM, Federman SM: Grip and pinch strength: norms for 6- to 19-year-olds. Am J Occup Ther 1986 Oct, 40(10):705-711.
- [38]Birke JA, Brandsma JW, Schreuders TA, Piefer A: Sensory testing with monofilaments in Hansen’s disease and normal control subjects. Int J Lepr Other Mycobact Dis 2000 Sep, 68(3):291-298.
- [39]Heikel HV: Aplasia and hypoplasa of the radius: studies on 64 cases and on epiphyseal transplantation in rabbits with the imitated defect. Acta Orthop Scand Suppl 1959, 39:1-155.
- [40]Kotwal PP, Varshney MK, Soral A: Comparison of surgical treatment and nonoperative management for radial longitudinal deficiency. J Hand Surg Eur Vol 2012 Feb, 37(2):161-169.