Effect of prostheses on children with congenital upper limb deficiencies

BACKGROUND

Individual weaknesses in motor skills are a characteristic of children with congenital upper limb deficiencies. These weaknesses increase with age. In Japan, however, prosthetic prescription and subsequent rehabilitation approaches for children with upper limb deficiencies are insufficient and often delayed. This study aimed to elucidate whether rehabilitation approaches, including prostheses prescription and occupational therapy, improve these children's adaptive behaviors, especially their motor skills.

METHODS

The study included nine children, aged 0-6 years, with unilateral transradial or transcarpal upper limb deficiencies. We measured their adaptive behaviors and motor skills at the beginning of prosthetic therapy and after 1.5 years, using the Vineland Adaptive Behavior Scales - Second Edition.

RESULTS

The score for the motor skills domain was significantly lower than the median score of the domains at the beginning of prosthetic therapy. The motor skill weaknesses significantly improved after 1.5 years of prosthetic therapy.

CONCLUSIONS

Although children with congenital upper limb deficiencies have individual weaknesses in their motor skill behavior, it was shown that these weaknesses can be improved through rehabilitation approaches, including occupational and prosthetic therapies. Issuing the appropriate prostheses and implementing the appropriate training to use the prostheses for congenital upper limb deficiencies are reasonable and meaningful interventions to improve quality of life.

Multidisciplinary treatment of non-syndromic oligodontia

Oligodontia is the agenesis of 6 or more teeth, excluding third molars. The etiology of congenital absence of teeth is believed to be rooted in heredity or developmental anomalies. The absence of teeth in patients can cause aesthetic, functional, and psychological problems, particularly if the anterior region is involved. This case report describes the multidisciplinary treatment approach toward a patient 17 years of age with non-syndromic oligodontia, with absence of 11 permanent teeth. Genetic counseling revealed non-syndromic, autosomal-recessive-linked oligodontia. The objectives of the first phase of therapy were pre-prosthetic orthodontic space opening for proper positioning of the missing teeth and correction of inter-maxillary relations, as a prerequisite for proper prosthetic restoration. The second phase of therapy was prosthetic restoration of the missing teeth and provision of occlusion with full-mouth porcelain fused to metal crowns and bridges after increasing occlusal vertical dimension by 2 mm.