Quantitative and qualitative functional evaluation of upper extremity tendon transfers in spastic hemiplegia caused by cerebral palsy

Ann E. Van Heest, Vimala Ramachandran, Jean Stout, Roy Wervey, Louis Garcia

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND:: The purpose of this study was to determine if upper extremity function and joint positioning improved after tendon transfer surgery in patients with spastic hemiplegia caused by cerebral palsy. METHODS:: Thirteen patients with spastic hemiplegia underwent tendon transfer surgery at a mean age of 10.8 years (range, 7-24 years). Before surgery, all patients were evaluated with a standardized motion laboratory analysis protocol. At a mean follow-up of 3.6 years (range, 1-10 years), 13 patients returned for a repeat motion laboratory analysis using the same protocol. The motion laboratory studies were then compared quantitatively, comparing times for completion of the Jebsen-Taylor hand test, and qualitatively for elbow, forearm, wrist, finger, and thumb positions using the validated Shriner's Hospital Upper Extremity Evaluation protocol. RESULTS:: In timed testing on the Jebsen-Taylor hand function test, 5 patients improved, 5 patients remained the same, and 3 patients worsened. No statistically significant change in timed testing was noted for any of the 6 subtests. A qualitative assessment of limb position during completion of tasks showed a significant improvement in position for the elbow (P < 0.01), forearm (P < 0.02), wrist (P < 0.02), and fingers (P < 0.02). There was no significant change in thumb position (P < 0.85). CONCLUSIONS:: Tendon transfers, especially for wrist extension, can be beneficial in improving upper extremity joint positioning in children with spastic hemiplegia. However, significant impairment in hand function persists.

Original languageEnglish (US)
Pages (from-to)679-683
Number of pages5
JournalJournal of Pediatric Orthopaedics
Volume28
Issue number6
DOIs
StatePublished - Sep 1 2008

Keywords

  • Cerebral palsy
  • Motion laboratory
  • Spastic hemiplegia

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