Hand dominance and scoliosis in Duchenne muscular dystrophy

Twenty-three patients with Duchenne muscular dystrophy and scoliosis were studied. In all but one patient the major convexity was to the side of the dominant hand. The unsupported growing spine is easily unbalanced by asymmetrical forces imposed on it. From our observations we believe major use of a single upper extremity will result in scoliosis with the major convexity toward the side of the dominant hand. Management should include counterbalancing the postural abnormality imposed by hand dominance as well as unloading the spine frequently during the patient's waking hours.