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Open Access Research article

Hand function in children with radial longitudinal deficiency

Anna Gerber Ekblom12*, Lars B Dahlin34, Hans-Eric Rosberg34, Monica Wiig56, Michael Werner7 and Marianne Arner12

Author affiliations

1 Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Hand Surgery, Stockholm, Sweden

2 Department of Hand Surgery, Södersjukhuset, Stockholm, Sweden

3 Department of Clinical Sciences Malmö, Section of Hand Surgery, Lund University, Malmö, Sweden

4 Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden

5 Department of Surgical Science, Hand Surgery, Uppsala University, Uppsala, Sweden

6 Department of Hand Surgery, Uppsala University Hospital, Uppsala, Sweden

7 Department of Radiology, Södersjukhuset, Stockholm, Sweden

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Citation and License

BMC Musculoskeletal Disorders 2013, 14:116  doi:10.1186/1471-2474-14-116

Published: 28 March 2013

Abstract

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.

Keywords:
Radial longitudinal deficiency; Aplasia of the radius; Radial aplasia; Radial club hand; Hand function; Children; Functional outcome; ICF-CY; AHA; CHEQ