title: Botulinum A chemodenervation: a new modality in cerebral palsied hands.
abstract: Botulinum A chemodenervation of the Adductor Pollicis muscle for the treatment of the thumb-in-palm deformity in cerebral palsied hands is presented as a new therapeutic option. Early results of a clinical trial in five hemiparetic Cerebral Palsied (C.P.) children are assessed using a prospective nontrialist-biased study design based on an independent panel assessment of pre- and post-intervention photographic and videotaped records of hand function and appearance, in combination with grip dynamometry and goniometry. All cases are shown to improve in terms of both function and appearance with results approaching statistical significance (p = 0.06) when assessed by the Wilcoxon's matched-pairs signed rank test, despite the small study group. The modality is shown to be simple, safe and effective over the period reported (229 days). The benefit is sustained beyond the period of muscle paresis and ongoing long term follow-up will document the need for, and timing of, reinjection.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of the Witwatersrand, South Africa.
authors.forename: S A
authors.initials: SA
authors.lastname: Wall
authors.forename: L A
authors.initials: LA
authors.lastname: Chait
authors.forename: J A
authors.initials: JA
authors.lastname: Temlett
authors.forename: B
authors.initials: B
authors.lastname: Perkins
authors.forename: G
authors.initials: G
authors.lastname: Hillen
authors.forename: P
authors.initials: P
authors.lastname: Becker
mesh_terms: D001905:Botulinum Toxins; D002547:Cerebral Palsy / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002986:Clinical Trials as Topic; D006225:Hand / Q000503:physiopathology; D006227:Hand Deformities, Acquired / Q000628:therapy*; D006801:Humans; D008297:Male; D009121:Muscle Denervation / Q000379:methods*; D011446:Prospective Studies; D013165:Splints; D013997:Time Factors; D014743:Videotape Recording
chemical_list: D001905:Botulinum Toxins