Duchenne muscular dystrophy: a study of wrist and hand function

The wrist and hands of 18 Duchenne muscular dystrophy (DMD) patients were assessed for abnormalities. The subjects were divided into three groups by age. Flexion and ulnar deviation contractures of the wrist began in the youngest age group, 8-14 years. Other abnormalities, present in all age groups, included extrinsic and intrinsic digital muscle shortness, boutonniere and swan neck deformities, and hyperextension of the digital interphalangeal joints. Pain found with passive proximal interphalangeal joint flexion has not been reported previously. This study supports the importance of early assessment of the wrist and hand in DMD and suggests intervention techniques to possibly retard the deforming process.