Bone age in unilateral spastic cerebral palsy: is there a correlation with hand function and limb length?

Author(s):  
Je-Sang Lee ◽  
Im Jeong Choi ◽  
Myung Jun Shin ◽  
Jin-A Yoon ◽  
Sung Hwa Ko ◽  
...  

AbstractBackground:The purpose of this study was to analyze the bone age and the upper extremity segmental lengths between the affected and the unaffected side and to reveal the correlation between the difference of bone age and the upper limb length discrepancy in the unilateral spastic cerebral palsy (CP). We also evaluated the relationship between difference of bone age and hand function.Methods:Seventy-eight patients participated in this study. The bone ages of hand-wrists of the patients were determined by the Greulich and Pyle atlas. Upper extremity segmental lengths were measured by radiograph. The side-to side length discrepancy was calculated as a percentage. Hand function was classified according to the Manual Ability Classification System (MACS).Results:There was significant difference in the bone age between the affected and unaffected side (p<0.001). Segmental lengths of the upper extremities showed significant differences between the affected and unaffected side (p<0.001). The hand function of 56 patients was evaluated by MACS and the MACS level showed correlation with difference of side-to-side bone age (r=0.29, p=0.03) and all segmental upper limb length discrepancies (p<0.05). The hand function in the bone-age-delayed group was significantly better than the hand function in the bone-age-symmetrical group (p<0.01).Conclusions:The bone age of the affected side compared to the unaffected side is delayed and the hand function of the affected side is correlated with the difference of side-to-side bone age and the upper limb length discrepancy. Hand function might be helpful for predicting potential limb shortness and delayed bone age.

2014 ◽  
Author(s):  
Yun Kyung Jeon ◽  
Myung Jun Shin ◽  
Sung Hwa Ko ◽  
Jae Hyeok Chang ◽  
Yong Beom Shin ◽  
...  

Children ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 17
Author(s):  
Ja Young Choi ◽  
Dong-Wook Rha ◽  
Seon Ah Kim ◽  
Eun Sook Park

The thumb-in-palm (TIP) pattern is one of the most common upper limb deformities in cerebral palsy (CP). This study was designed to investigate the effect of the dynamic TIP pattern on upper limb function in children with spastic CP. This prospective observational study included a total of 106 children with CP with dynamic TIP. The House TIP classification while grasping small or large objects, Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Shriners Hospital Upper Extremity Evaluation (SHUEE), Zancolli classification for wrist–finger flexor deformity, and degree of swan neck deformity were assessed. Type I was the most common and highest functioning House TIP classification type. However, there were no significant differences in upper arm function between types II, III, and IV. The three components of the SHUEE showed stronger association with MUUL than House TIP and Zancolli classifications. After multivariable analysis, functional use of the wrist–finger and the thumb played a more significant role than the dynamic alignment of the thumb. In conclusion, the House TIP classification is useful to describe the TIP pattern. The SHUEE thumb assessment is a useful tool for reflecting upper arm function. The upper arm function was related more with the associated wrist flexor deformity than dynamic TIP.


2020 ◽  
Vol 9 (12) ◽  
pp. 4104
Author(s):  
Lukas Zak ◽  
Thomas Manfred Tiefenboeck ◽  
Gerald Eliot Wozasek

Limb length discrepancy (LLD) is a common problem after joint-preserving hip surgeries, hip dysplasia, and hip deformities. Limping, pain, sciatica, paresthesia, and hip instability are common clinical findings and may necessitate limb-lengthening procedures. The study included five patients (two female and three male, mean age of 28 years (20–49; SD: 12)) with symptomatic limb length discrepancy greater than 2.5 cm (mean: 3.6 cm) after total hip arthroplasty (THA), hip dysplasia, or post-traumatic hip surgery. They underwent either ipsi- or contralateral intramedullary limb-lengthening surgeries using the PRECICE™ telescopic nail. All patients achieved complete bone healing and correction of the pelvic obliquity after intramedullary lengthening. None of the patients had a loss of proximal or distal joint motion. The mean distraction-consolidation time (DCT) was 3.8 months, the distraction index (DI) 0.7 mm/day, the lengthening index (LI) 1.8 months/cm, the consolidation index (CI) 49.2 days/cm, the healing index (HI) 1.1 months/cm, and the modified healing index (HI*) 34 days/cm. Intramedullary limb lengthening after LLD in cases of hip dysplasia, hip deformity, and various kinds of hip surgery is a useful and safe procedure in young patients to achieve equal limb length. No functional impairment of the preceded hip surgery was seen.


1987 ◽  
Vol 69 (5) ◽  
pp. 699-705 ◽  
Author(s):  
W W Huurman ◽  
F S Jacobsen ◽  
J C Anderson ◽  
W K Chu

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