Congenital skeletal deficiencies in upper limb in a pediatric population: 27 years Revision

Abstract

Congenital skeletal deficiencies are the principal cause of upper limb amputation in the first decade of life whereas between the ages of 10 to 20 years is trauma.
The first prosthesis of children with upper congenital limb deficiency must be adapted between 3 and 9 months in order to contribute to psychological and motor development, allowing the use of both upper limbs to crawl and assuming the standing position. Using a prosthesis later (2 to 5 years) results in a higher rejection rate because at this age, children already developed compensatory techniques. The steps of psychological and motor development are used to guide the prosthesis and components prescription.

Material and Methods: The authors made a retrospective study consulting clinical files of children followed in consultation in the Paediatric Development and Rehabilitation Service, from 1980 and 2007, with the diagnostic of upper limb amputations and congenital deficiencies. From this population, the children with prosthesis were selected and divided in two groups according to diagnostic. The final goal was to evaluate the efficacy of prosthesis utilization in this population.

Results and Conclusion: The prescription at the correct time, the adequate rehabilitation program and family teaching are the key points for the child's functional independence. However, it is important to separate the concept of prosthesis function and its use. Benefits and losses should be discussed before prescription and beginning of rehabilitation treatment.

Key words: cild, amputees, upper limb