MUSCULOSKELETAL SURGERY

, Volume 96, Issue 3, pp 199–204

Wrist fusion in patients with severe quadriplegic cerebral palsy

  • Ahmed M. Thabet
  • Durga Nagaraju Kowtharapu
  • Freeman Miller
  • Kirk W. Dabney
  • Suken A. Shah
  • Kenneth Rogers
  • Laurens HolmesJr.
Original Article

DOI: 10.1007/s12306-012-0217-0

Cite this article as:
Thabet, A.M., Kowtharapu, D.N., Miller, F. et al. Musculoskelet Surg (2012) 96: 199. doi:10.1007/s12306-012-0217-0

Abstract

We report clinical and radiographic outcomes of wrist fusion achieved with pin or plate fixation in 14 patients with severe quadriplegic cerebral palsy (CP) (19 wrists). Average patient age at the time of surgery was 16.8 ± 1.7 years (14–20 years). Mean follow-up time for the 14 patients was 5.9 ± 3.1 years (range, 1–11 years). Indication for surgery was severe wrist deformity that interfered with hygienic care. Few complications occurred, and outcomes were satisfactory. Statistically significant mean difference was shown between the pre- and postoperative radiographic angles (37°, P = 0.001, and 24°, P = 0.04, for lateral and anteroposterior views, respectively). Caregivers reported that appearance was the most perceived rationale for surgery (63 %). Improved hygienic care was the primary perceived benefit. The majority (88 %) were satisfied with the results. We recommend wrist fusion to improve hygienic care, positioning, and appearance of the wrist, hand, and fingers in patients with severe quadriplegic CP.

Keywords

Cerebral palsy Quadriplegic Wrist fusion Flexion deformity 

Copyright information

© Istituti Ortopedici Rizzoli 2012

Authors and Affiliations

  • Ahmed M. Thabet
    • 1
    • 2
  • Durga Nagaraju Kowtharapu
    • 1
  • Freeman Miller
    • 1
    • 3
  • Kirk W. Dabney
    • 1
  • Suken A. Shah
    • 1
  • Kenneth Rogers
    • 1
  • Laurens HolmesJr.
    • 1
  1. 1.Department of OrthopedicsAlfred I. duPont Hospital for Children, Nemours Children’s ClinicWilmingtonUSA
  2. 2.Orthopedics DepartmentBenha Medical SchoolBenhaEgypt
  3. 3.Chief of Cerebral Palsy Program, Alfred I. duPont Hospital for ChildrenNemours Children’s ClinicWilmingtonUSA

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