Upper extremity shortness in children with hemiplegic cerebral palsy.
OBJECTIVE
To evaluate upper extremity shortness in patients with hemiplegic cerebral palsy (HCP) and to investigate the association between extremity shortness, motor level, and muscle tone.


METHODS
Prospective, controlled study.


METHODS
Forty-two children with HCP and 29 healthy children.


METHODS
Radiographs of the involved and the uninvolved humerus, forearm, and hands were obtained with a radiographic ruler placed adjacent to the extremity. The lengths and the diameters of both the diaphyses and metaphyses of the humerus, ulna, radius, and the second and the fifth metacarpal bones were measured in patients and the control group. The discrepancy was calculated as a percentage compared with the normal side. The Ashworth Scale was used in the evaluation of spasticity, and the Brunnstrom recovery staging was used in the motor evaluation.


RESULTS
Children with HCP had significant differences in bone lengths and diameters compared with control children. There was no significant correlation between the upper extremity Brunnstrom stagings and the differences of bone length and diameter. A significant correlation was observed between the hand Brunnstrom staging and percentage difference of the bone length and diameter. The spasticity level showed no relation to the differences in bone length and diameter.


CONCLUSIONS
Children with HCP have significant side-to-side limb-length discrepancy when compared with control children. The discrepancy increases with age. The extent of shortening did not appear to be related to upper extremity function and spasticity. The extremity shortness showed a relation to hand function.
Demir
Sibel Ozbudak
SO
Ankara Physical Medicine, Rehabilitation, Education and Research Hospital of the Ministry of Health, Ankara. sibiozbudak@hotmail.com
Oktay
Fügen
F
Uysal
Hilmi
H
Seluk
Barin
B
D002547:Cerebral Palsy / Q000150:complications*; D002675:Child, Preschool; D005260:Female; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology*; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index