Long-term results of forearm shortening and volar radiocarpal capsulotomy for wrist flexion deformity in children with amyoplasia

摘要

Purpose: To perform a long-term review of results of forearm shortening osteotomies, tenotomy, and volar wrist capsulotomy for treatment of typical wrist flexion deformities in children with the amyoplasia form of arthrogryposis, a procedure originally reported and described as "most rewarding" by Lexington Shriners Hospital for Children in 1965. Methods: A retrospective review of operating room and clinic records was done. An attempt to contact all patients produced 1 current follow-up. Results: Nine extremities in 6 patients had undergone the procedure. Of the 9 extremities, 3 subsequently underwent salvage procedures, 2 had salvage procedures recommended, and 1 had a distal forearm fracture angular malunion that compensated for the wrist flexion contracture. The charts for the patients with the 3 remaining extremities showed that at 3-year follow-up, the wrist flexion contractures had recurred. Conclusions: Long-term follow-up of the procedure shows that the initial improvement in wrist position is not maintained. This procedure is not recommended for correction of the wrist deformity in amyoplasia. Type of study/level of evidence: Therapeutic IV.