Unilateral Upper Extremity Transverse Deficiencies: Prosthetic Use and Function

Background: Children with upper extremity transverse deficiency are assumed to have significant disability associated with their malformation, and use of prosthesis has been presumed to be necessary to reduce this disability. However, standardized methods of measuring function and prosthesis use have not been widely applied to this population, and their prosthesis rejection rates are high. Methods: This article reviews the measurement of hand function in children, and evidence regarding the usefulness of prostheses for children with transverse deficiency. Results: There are several different questionnaires and function tests available to measure hand function in children. Most are specialized, time consuming and incompletely validated. Conclusion: Children with transverse deficiency have close to normal function and quality of life, and prosthesis use is not associated with improvements in these areas. Further research is needed to develop better methods of measuring function. Currently available prostheses may help with social acceptance or be useful as tools for specific activities, but they do not improve daily function or quality of life.