2. To encourage hand therapistsall over the world to marketthe profession among quiltersand other crafters, as we canenable them to continue prac-ticing their craft.

ELBOW FLEXIONCONTRACTURES INCHILDREN WITHOBSTETRICALBRACHIAL PLEXUSPALSY

Emily Ho, The Hospital for SickChildren, University of Toronto,Trisha Roy, Howard Clarke,Canada

Purpose: Elbow flexion contrac-tures are a common sequela in ob-stetrical brachial plexus palsy(OBPP). The etiology of these con-tractures is unclear. Non-operativetreatment involving serial castingand splinting is indicated in theliterature. The purpose of this studyis to evaluate the effectiveness ofnon-operative treatment of elbowflexion contractures in children withOBPP.

Methods: A retrospective reviewof children with OBPP who partici-pated in serial casting and splintingfor an elbow flexion contracture wasconducted. Elbow extension range ofmotion (ROM) measurements at ini-tial, best-achieved, and final outcomewere compared.

Results: Nineteen (n 5 19) pa-tients, aged 2 to 16 years, were stud-ied. Elbow ROM improved frominitial to best-achieved and final out-come measurements.

Conclusions: Serial casting andsplinting of elbow contractures inchildren with obstetrical brachialplexus palsy is effective. Successfulmaintenance of treatment effects isdependent on age and compliance.

Relevance: Serial casting andsplinting is an effective interventionin improving elbow flexion contrac-tures in children with obstetricalbrachial plexus palsy. Therapistsshould spend time educating patientsand families regarding the commit-ment required to participate in thistreatment to ensure compliance andsuccessful outcome.

OBJECTIVES

1. To demonstrate the effective-ness of serial casting andsplinting as an intervention toimprove elbow flexion con-tractures in obstetrical brachialplexus palsy.

2. Present a clinical decision treeand treatmentprotocol for serialcasting and splinting of elbowflexion contractures in obstetri-cal brachial plexus palsy.

STRATEGIC CHOICEAND TIMING OF UPPEREXTREMITY SPLINTSAND ADL AIDES IN THETREATMENT OFARTHROGRYPOSISMULTIPLEXCONGENITA

Tracy C. Fairplay, Policlinico diModena, Silvana Sartini, Italy

Purpose: This brief paper de-scribes the appropriate timing ofphysical therapy and occupationaltherapy upper extremity treatmentin the global care of the arthrogry-potic child.

Methods: The key to treating thearthrogrypotic deformity is to imme-diately address the child’s articularor peri-articular rigidity during thefirst weeks of life. The physical ther-apy regimen emphasizes early pas-sive stretching and serial splinting toimprove joint motion during limbgrowth, and to prevent contractureprogress or re-occurrence. Thegrowth years must therefore be dom-inated by physical management,which consists of stretching, casting,and bracing interspersed by stagedsoft-tissue procedures and the use ofadaptive equipment to render thepatient more autonomous in theiractivities of daily living. At comple-tion of limb growth, final surgicalcorrections should be attained by os-teotomies. Adolescence should be atime to follow social and prevoca-tional pursuits in preparation for aplace in society.

Results: Clinicians attempt toovercome these limitations throughinterventions that focus on remedia-tion, adaptation and/or compensa-tion. Remediation techniques target

the problem at the level of impair-ment in an effort to promote normalfunctioning. Adaptation involvesmodifications to the environment toallow access for the child with afunctional impairment, while com-pensation involves the use of assis-tive devices to circumvent thefunctional impairment.

Conclusions: Children afflictedwith Arthrogryposis require ongoingcare with a skillfully and timelydelivery of medical services. Closecollaboration is needed betweenmedical professionals, educatorsand the child’s family members inorder to enhance both quality andautonomous function throughout thechild’s growing years.

Relevance: Functional splintingand assistive devices are providedto arthrogrypotic children with func-tional impairments to increase inde-pendence and age appropriatefunction. The physical and occupa-tional therapist play a vital role inhelping the child to achieve andmaintain their maximal functionalautominomy throughout the growingyears and in association with surgicalfunctional interventions.

OBJECTIVES

1. To present a timely guidelinein regards to splinting theAMC infant and childthroughout their growingyears.

2. To present a timely guidelinein regards to the use of func-tional adaptive equipment inthe AMC patient.

RADIAL DYSPLASIA: APROPOSAL FOREVALUATION ANDREHABILITATIONPROGRAM IN THESURGICAL TREATMENTOF INDEXPOLLICISATION

Silvana Sartini, Policlinico diModena, Tracy Fairplay,Annalisa Nesti, ItalyPurpose: This brief paper would

like to propose an evaluation andpre and post operative sequential

October–December 2010 e19