title: Hand function in children with radial longitudinal deficiency.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Section of Hand Surgery, Stockholm, Sweden. anna.gerber.ekblom@ki.se
authors.forename: Anna Gerber
authors.initials: AG
authors.lastname: Ekblom
authors.forename: Lars B
authors.initials: LB
authors.lastname: Dahlin
authors.forename: Hans-Eric
authors.initials: HE
authors.lastname: Rosberg
authors.forename: Monica
authors.initials: M
authors.lastname: Wiig
authors.forename: Michael
authors.initials: M
authors.lastname: Werner
authors.forename: Marianne
authors.initials: M
authors.lastname: Arner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging* / Q000502:physiology*; D006801:Humans; D008297:Male; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging* / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*
references.citation: J Bone Joint Surg Am. 1977 Jan;59(1):1-13
references.pmid: 833156
references.citation: Dev Med Child Neurol. 2011 May;53(5):436-42
references.pmid: 21413973
references.citation: Scand J Rehabil Med. 1999 Jun;31(2):95-100
references.pmid: 10380725
references.citation: J Hand Surg Am. 2000 Jul;25(4):745-51
references.pmid: 10913218
references.citation: J Bone Joint Surg Am. 2005 May;87(5):1038-46
references.pmid: 15866967
references.citation: Hum Genet. 1983;65(1):27-33
references.pmid: 6642505
references.citation: Am J Occup Ther. 1999 Jan-Feb;53(1):83-90
references.pmid: 9926224
references.citation: J Hand Surg Am. 1984 Jul;9(4):541-7
references.pmid: 6747239
references.citation: J Hand Surg Am. 1985 Nov;10(6 Pt 2):964-8
references.pmid: 4078287
references.citation: Am J Occup Ther. 1986 Oct;40(10):705-11
references.pmid: 3777107
references.citation: J Hand Surg Am. 2012 Oct;37(10):2082-7
references.pmid: 23021174
references.citation: Acta Orthop Scand Suppl. 1959;39:1-155
references.pmid: 14400621
references.citation: Clin Genet. 1989 May;35(5):322-30
references.pmid: 2788043
references.citation: J Hand Surg Am. 1999 Nov;24(6):1132-44
references.pmid: 10584933
references.citation: Disabil Rehabil. 2013 Aug;35(16):1401-7
references.pmid: 23167292
references.citation: Teratology. 1989 Feb;39(2):127-35
references.pmid: 2784595
references.citation: J Hand Surg Am. 2002 Jan;27(1):118-24
references.pmid: 11810625
references.citation: Dev Med Child Neurol. 2007 Apr;49(4):259-64
references.pmid: 17376135
references.citation: J Hand Surg Br. 1998 Aug;23(4):445-52
references.pmid: 9726542
references.citation: J Bone Joint Surg Am. 1981 Jun;63(5):741-5
references.pmid: 7240297
references.citation: Scand J Rehabil Med. 1990;22(3):127-34
references.pmid: 2244189
references.citation: J Hand Surg Am. 1999 Nov;24(6):1145-55
references.pmid: 10584934
references.citation: J Hand Surg Am. 2006 Sep;31(7):1176-82
references.pmid: 16945723
references.citation: J Hand Ther. 1998 Oct-Dec;11(4):251-7
references.pmid: 9862262
references.citation: J Hand Surg Am. 2006 Jul-Aug;31(6):960-7
references.pmid: 16843156
references.citation: J Bone Joint Surg Am. 2008 Nov;90(11):2408-15
references.pmid: 18978409
references.citation: J Hand Surg Am. 1987 Mar;12(2):169-79
references.pmid: 3559066
references.citation: Am J Med Genet. 2001 Jun 1;101(1):26-32
references.pmid: 11343333
references.citation: AMA Am J Dis Child. 1955 Jun;89(6):725-42
references.pmid: 14375378
references.citation: J Hand Surg Eur Vol. 2012 Feb;37(2):161-9
references.pmid: 21708841
references.citation: Acta Paediatr. 2006 May;95(5):600-13
references.pmid: 16825142
references.citation: Eur J Med Genet. 2010 Sep-Oct;53(5):286-90
references.pmid: 20670696
references.citation: Int J Lepr Other Mycobact Dis. 2000 Sep;68(3):291-8
references.pmid: 11221092
references.citation: J Hand Surg Am. 2010 Nov;35(11):1742-54
references.pmid: 20961708
references.citation: J Hand Surg Am. 1981 Sep;6(5):423-33
references.pmid: 7276473