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Bones of the Upper Limb: Radius01:09

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Related Experiment Video

Updated: Nov 22, 2025

Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
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Congenital Upper Limb Differences Registry (CoULD): Registry Inclusion Effect.

Carley Vuillermin1, Maria F Canizares1, Andrea S Bauer1

  • 1Harvard Medical School, Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA.

The Journal of Hand Surgery
|January 11, 2021
PubMed
Summary

The Congenital Upper Limb Differences (CoULD) registry shows different condition frequencies than prior studies, reflecting tertiary care. An early registry inclusion effect stabilized by year three.

Keywords:
Congenital differencedatabaseinclusion effectprevalencerelative frequency

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Area of Science:

  • Pediatric Orthopedics
  • Epidemiology
  • Medical Registries

Background:

  • Understanding congenital upper limb differences is crucial for effective treatment.
  • Multicenter registries are valuable tools for epidemiological research.

Purpose of the Study:

  • To compare the Congenital Upper Limb Differences (CoULD) registry population with previous studies.
  • To evaluate changes in condition frequencies over time within the CoULD registry.
  • To identify and assess the registry inclusion effect.

Main Methods:

  • Analysis of 4-year data from the CoULD registry (2 founding centers).
  • Comparison of the CoULD cohort with two prior cross-sectional studies.
  • Classification of conditions using the Oberg-Manske-Tonkin system.
  • Calculation of relative frequencies for selected conditions to assess temporal changes.

Main Results:

  • The CoULD registry (1,381 patients) exhibited different prevalence rates compared to US Midwest and Swedish birth registries.
  • Approximately 33% of diagnosis categories showed prevalence differences.
  • The registry captured more late-presenting and non-surgical pathologies.
  • Registry inclusion effects on condition frequencies occurred early and stabilized by the third year.

Conclusions:

  • The CoULD registry provides a distinct relative frequency of congenital upper limb differences compared to prior research.
  • The registry may offer a more accurate representation of clinical practice in tertiary referral settings.
  • A significant registry inclusion effect was identified, emphasizing the importance of data stability.