Abstract
BackgroundIn 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.MethodsTwenty 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.ResultsThe 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.ConclusionIn 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.
Highlights
In children with hypoplasia or aplasia of the radius 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
In 18/25 limbs, surgical wrist correction had been performed, whereof 13 with prior soft tissue distraction Twelve of 25 limbs had been operated by radialization procedure [16], 6/25 by a nonnotched centralization procedure [36] and three had undergone ulnar lengthening by callus distraction
The present study describes a small number of children with Radial longitudinal deficiency (RLD), but with a wider perspective than commonly used since the different domains in the ICF-CY framework were used
Summary
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 more pronounced anomalies are characterized by a short and radially bowed forearm, radial deviation of the wrist, stiff fingers and a sub-functional or absent thumb. In these individuals, not Previous studies have mainly focused on the results of surgery [6,11,12,13,14,15]. The focus of the present study was to investigate the relations between different components of the deformity and the activity and participation among individuals with RLD, regardless of type of deformity and prior treatment
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