A clinical approach to a child with mirror hand malformation: 8-year follow-up results

Abstract

Mirror hand (ulnar dimelia) is a very rare congenital anomaly of the upper extremity. This report presents the results of a therapy programme given to a patient with mirror hand. Pollicisation, opponensplasty, triceps lengthening and elbow arthrolysis were performed when the child was 2, 3, 4 and 7 years old respectively. Hand rehabilitation was planned in early (4–8 weeks), mid (9–12 weeks), and late (12 weeks) postoperative periods. The main purposes of the rehabilitation were to help the child recognise their hands and to use them functionally, ensure cortical reorganisation, improve independence and participate in activities of daily living. Range of motion, muscle and grip strength, sensation and hand function assessment results from an 8-year follow-up are presented. After 8 years of follow-up, the child was able to use his hand functionally, his grip strength was 1 kg, and his sensation was typical. Although he was independent in performing activities of daily living, because he did not have sufficient elbow flexion, he used excessive wrist flexion in some activities. The treatment was satisfactory for the child and the family. The child displayed typical motor development similar to his peers. Planning the treatment and therapy in coordination with hand surgeons is essential for optimal hand function.