PMID: 16518096Mar 7, 2006Paper

Carpal wedge osteotomy for the arthrogrypotic wrist

Techniques in Hand & Upper Extremity Surgery
Marybeth Ezaki, Peter R Carter

Abstract

The upper limbs of the child with the amyoplasia form of arthrogryposis are typically internally rotated at the shoulders, extended at the elbows, and flexed and deviated ulnarly at the wrists. This position results in an obligatory crossed-limb pattern of bimanual use, as neither hand is sufficiently strong or agile to function independently. A change in the position of deformity to one that allows the palms to come together without crossing the arms, and also allows access to desktops and keyboards, is a reasonable goal for children with this condition. A severe internal rotation deformity at the shoulder can be corrected with external rotation osteotomy, and elbow extension contractures can be released with soft-tissue procedures to increase the passive range of motion. However, most attempts to improve wrist position have been disappointing because they have resulted in the loss of any limited motion that might be present. This paper describes a technique of resection of a portion of the carpus that improves position and retains motion because it spares the radiocarpal joint.

References

Jun 1, 1993·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·U Mennen
Oct 1, 1996·Pediatric Clinics of North America·A E Van Heest
Jul 1, 1997·Journal of Pediatric Orthopedics. Part B·M W AxtM Weber

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Citations

Dec 27, 2012·The Journal of Hand Surgery·Ann E Van Heest, Rudy Rodriguez
Apr 8, 2015·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Amy L Lake, Scott N Oishi
Sep 11, 2014·Journal of Pediatric Orthopedics·Donald S Bae, Charles A Goldfarb
Oct 5, 2016·Hand : Official Journal of the American Association for Hand Surgery·Michael B GottschalkHilton P Gottschalk
Nov 1, 2018·Revista Brasileira De Ortopedia·Ricardo Kaempf de OliveiraSamuel Ribak
Oct 18, 2013·The Journal of Bone and Joint Surgery. American Volume·Christian A FoyScott N Oishi
Jul 4, 2019·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Scott OishiTerri Beckwith
Jul 28, 2019·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Marianne GagnonNoémi Dahan-Oliel
Jul 31, 2019·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Luisa M RodriguezLouis-Nicolas Veilleux
Oct 22, 2014·JBJS Essential Surgical Techniques·Scott N OishiMarybeth Ezaki
Jun 9, 2017·Journal of Pediatric Orthopedics·Scott N OishiLesley Butler

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