Abstract
Purpose of study
To determine whether hemiplegia causes abnormal torsion of the radius of the affected compared with the unaffected limb as demonstrated by MRI measurements, and to assess whether this correlates with the passive range of movement as measured clinically.
Methods
27 patients who fit the inclusion criteria were recruited from an existing database of hemiplegic patients into our prospective cohort study.
A clinical assessment was made of each subject to determine the range of active and passive upper limb movements. A functional assessment of the children's upper limbs was made using the validated House score. Subsequent MRI scans of both upper limbs were then performed. A single radiologist (blinded as to the affected limb) then measured the torsional profiles of both radii using a method validated by Bindra et al.
Results
9 patients have thus far undergone MRI scanning, and the cohort will be completed within the next 3 months. Those with the lowest House scores generally had the smallest range of combined forearm pro-supination on the affected side. The torsion of the radii on MRI of the affected side was greater than on the non-affected side in the majority of cases.
Conclusions
The lower limbs of children with diplegia can develop significant torsion with growth, but little is known about torsion in the upper limb bones of children with hemiplegia. The study showed a difference in the range of movement of the upper limbs in children with hemiplegic cerebral palsy. This correlated with an observed difference in the torsional profiles of the radii when measured on MRI.
