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Outcome of Centralization and Ulnarization of the Carpus with Ulnar Shortening Osteotomy on Functioning in Children

Sakti Prasad Das1, G Shankar Ganesh2

  • 11Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, Cuttack, Odisha 754010 India.

Indian Journal of Orthopaedics
|April 8, 2020
PubMed

Insights

Surgery for radial club hand improves upper extremity structure but shows limited impact on overall functioning. Both centralization and ulnarization techniques yielded similar functional outcomes in children.

Area of Science:

  • Orthopedic surgery
  • Pediatric rehabilitation
  • Reconstructive surgery

Background:

  • Radial club hand (RCH) presents diverse upper limb anomalies.
  • Previous RCH studies focused on clinical and radiological outcomes.
  • Patient-centered care necessitates evaluating functional outcomes.

Purpose of the Study:

  • Identify functioning components in RCH.
  • Assess surgical effectiveness on function using ICF tools.
  • Compare centralization vs. ulnarization with osteotomy for functional outcomes.

Main Methods:

  • 14 children (Bayne types III-IV) with RCH were studied.
  • Group 1: Centralization surgery. Group 2: Ulnarization with osteotomy.
  • Outcomes assessed using ICF core sets for children and hand conditions.

Main Results:

  • Both techniques improved upper extremity structure (s730).
  • Significant improvements noted in hand/arm use (d445), toileting (d530), and play (d880).
  • No significant improvement in muscle power (b730), tone (b735), fine motor skills (d440), or play (d880).

Conclusions:

  • Surgical interventions for RCH primarily enhance structural and cosmetic aspects.
  • Current surgical approaches show limited effectiveness in improving overall limb function.
  • Further research is needed to optimize functional outcomes in RCH patients.
Abstract

Keywords:
Congenital hand deformitiesDisabled childrenInternational Classification of Functioning, Disability, and HealthOperativeOutcomeRehabilitationSurgical proceduresTreatment outcome

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