Hand function in patients with spina bifida cystica.

Area of Science:

• Pediatric Orthopedics
• Neuroscience
• Rehabilitation Medicine

Background:

• Myelomeningocele is a complex congenital condition affecting neurological and musculoskeletal development.
• Hand function deficits are common in individuals with myelomeningocele, impacting daily activities.
• Understanding factors influencing hand function is crucial for effective management.

Purpose of the Study:

• To evaluate hand function in patients with myelomeningocele using the Jebsen-Taylor hand function test.
• To identify correlations between neurological level, hydrocephalus management, and hand function outcomes.
• To inform realistic expectations and management strategies for healthcare professionals and families.

Main Methods:

• The Jebsen-Taylor hand function test was administered to 143 myelomeningocele patients aged 8-35.
• Hand function was compared between patients and age/sex-matched normal individuals.
• Data were analyzed to assess the impact of lesion level and shunt surgery history.

Main Results:

• Patients with myelomeningocele showed significantly impaired hand function compared to controls.
• Poorer hand function was observed in individuals with thoracic and high lumbar level myelomeningocele.
• More than three shunt operations for hydrocephalus correlated with a higher likelihood of abnormal hand function.

Conclusions:

• Myelomeningocele significantly impacts hand function, with severity related to lesion level and hydrocephalus treatment history.
• These findings underscore the importance of tailored rehabilitation and realistic goal-setting for children with myelomeningocele.
• Orthopedic surgeons, therapists, and parents should collaborate to optimize functional outcomes and expectations.