|
Upper limb deficiency is generally referred to by professionals
using two broad definitions - a Transverse or a Longitudinal deficiency.
The Transverse Deficiency results in the limb coming to an abrupt
end with no further development. This leaves a limb which may resemble
an amputation stump. Artificial limbs are more suited to this type
of deficiency.
Where the difference is a longitudinal one, there is a reduction
or absence of some skeletal elements within the limb and normal
elements may be present after the affected area. There may also
be muscle or soft tissue deficiency. For this type of limb deficiency
the parents are often offered surgical techniques which may improve
function and/or appearance of the limb.
|
 |
Surgical techniques vary from hospital to hospital but Reach
has information on the following:
Policisation - the rotation of the fore finger to create a thumb
Radial Aplasia - the repositioning of the hand by several methods.
splinting, Illizarof frame, surgical splinting
Toe to Hand transfer -the moving of 1 or 2 toes from the child's
feet to the hand to create two digits and increase function
Bone Transfer - often an alternative to whole toe transfer. Bone
is moved from the feet or other area of the body to 'fill' in complete
digits in the hand.
Digital Lengthening - The use of a metal frame to stretch the
bones present in the hand to form digits.
Reconstruction - surgery performed on the hand or arm to improve
either the function or cosmetic appearance or both.
| The decision to proceed with surgery is often a difficult
one for parents and as much information should be gathered before
making this decision. We recommend if at all possible families should
seek the opinion of two surgeons experienced in reconstruction of
the hand. We also recommend that all children are seen by a Rehabilitation
Team at their local Limb Centre (often referred to as a Disablement
Service Centre) as recommended by the Association of Medical Rehabilitation
Surgeons in their standards of care document dated December 1991. |
 |
|
