How Risky Are Risk Factors? An Analysis of Prenatal Risk Factors in Patients Participating in the Congenital Upper Limb Differences Registry

Schaeffer, Tyler; Canizares, Maria F.; Wall, Lindley B.; Bohn, Deborah C.; Steinman, Suzanne; Samora, Julie Balch; Manske, M. Claire; Hutchinson, Douglas T.; Shah, Apurva S.; Bauer, Andrea S.; Bae, Donald S.; Goldfarb, Charles A.; Cook, David

doi:10.1016/j.jhsg.2022.03.001

Cited by 4 publications

(2 citation statements)

References 41 publications

(26 reference statements)

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“…The registry seeks to describe the epidemiology, clinical characteristics, function, and health status of children with CULD and the quantification of improvements with surgical and nonsurgical care. This registry engendered multiple publications and ongoing research studies instrumental to better understanding the demographics, function, and outcomes of children with CULD 1,14,15,53,[56][57][58][59][60][61][62][63][64][65][66][67] .…”

Section: Additional Resourcesmentioning

confidence: 99%

Team Approach: The Care of Children with Hand and Upper Limb Differences

2023

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» Pediatric hand and upper limb differences include a wide range of conditions that may be genetic, part of a syndrome, or arise from birth trauma or an unknown cause.» Because of the variety of conditions and complexity of care requiring professionals from multiple disciplines, the Pediatric Hand Team is similar in purpose to the coordinated multidisciplinary care provided by Craniofacial Panels for children with craniofacial anomalies. Pediatric hand surgeons are trained to lead and coordinate the care of children with these differences, and the Pediatric Hand Team includes occupational and/or certified hand therapists, child life specialists, geneticists and genetic counselors, prosthetists and orthotists, pediatric physical medicine and rehabilitation physicians, pediatric orthopaedic surgeons, pediatric anesthesiologists, and social workers and psychologists. The Team must also have access to pediatric imaging, including ultrasound and magnetic resonance imaging.» Treatment of hand differences may include observation, splinting/bracing, therapy, reconstructive surgery, or a combination of these, and indications vary with development, age, associated conditions, and child and family preference. Children who have challenges coping with the stigma of their difference may benefit from programs such as Hand Camp and the Lucky Fin Project.» Multiple online and print resources are available to support the Pediatric Hand Team and the child's family and other caregivers.» A well-coordinated team-based approach meets the physical and psychosocial needs of the child with hand and upper limb differences from birth to adulthood.

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Section: Additional Resourcesmentioning

confidence: 99%

Team Approach: The Care of Children with Hand and Upper Limb Differences

2023

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“…The authors also proposed a modification of the Blauth classification system to add a type 6 (patterns A through E), which includes the absence of other digits beyond the thumb 83 . The CoULD registry was also utilized to analyze prenatal risk factors, and Schaeffer et al found that, among the 29% of patients with an identifiable risk factor, prenatal maternal prescription drug use was the most frequent (16%) 84 . In reviewing 150 cases of thumb polydactyly in the registry and comparing 3 separate classification systems, the Wassel-Flatt and Rotterdam classifications were found to have excellent interrater and intrarater reliability 85 .…”

Section: Upper Extremitymentioning

confidence: 99%

What’s New in Pediatric Orthopaedics

Andras

Sanders²,

Goldstein

et al. 2022

Journal of Bone and Joint Surgery

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This pediatric orthopaedic update represents a review of articles predominantly from October 2021 to October 2022. Spine Adolescent Idiopathic ScoliosisAs we strive toward optimal adolescent idiopathic scoliosis treatment that will serve patients well into adulthood, longterm follow-up studies are of particular importance. Lander et al. reported on a series of 134 patients treated with Harrington instrumentation with a minimum 40-year follow-up. Patients with a lowest instrumented vertebra (LIV) at L3 or proximal had a lower likelihood of undergoing additional surgical procedures at 13% compared with patients with an LIV at L4 or distal at 36%, but, aside from this, the groups were similar with regard to health-related quality of life and their scores were not different from normal age-based means 11 . Also encouraging was the report on 115 patients with a 25year follow-up that showed that the serum levels of cobalt and chromium ions were similar in the patients treated with Harrington instrumentation compared with a control group of patients treated with bracing 12 . However, questions with regard to the long-term effect of retained implants continue to generate concern as titanium levels were found to be persistently elevated to 5 times the preoperative level at the 2-year follow-up in a series with more contemporary implants 13 . The impact of this remains unknown but warrants continued study.There remains continued interest in leveraging technology to achieve optimal pedicle screw placement safely and consistently. In a systematic review and meta-analysis by Baldwin et al., screws placed with intraoperative computed tomographic (CT) navigation were determined to be one-third Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H355).

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