Physical features and complaints in Unilateral Congenital Below-Elbow Deficiency: a 23 year follow-up study.

Current management of children with Unilateral Congenital Below-Elbow Deficiency (UCBED) suggests prosthetic fitting at an early age. One of the reasons for this, is the hypothesis that the weight and use of a prosthesis prevents physical problems at a later age. However, there is no scientific evidence for this theory. This study aims to describe the physical features of the trunk, spine and arms in persons with UCBED, compared to matched controls and describe the change of these features over time, to describe physical complaints in this population and to reveal whether prosthetic use has an influence on the physical features and complaints. Twenty-eight persons with UCBED, who were fitted with a prosthesis at the Limb Deficiency and Prosthesis Centre in Örebro, Sweden, were invited to the clinic twice, for physical measurements and filling in questionnaires. Measurements were conducted in 1987 (age range of patients: 8-18 years) and 2011 (age range: 32-42 years), making this a 23 year follow-up study. In 1987, differences were found in the trunk, upper arm volume and spine between patients and their matched controls, which continued to exist on a later age. Spinal deviations were both in 1987 and 2011 greater in the patients, compared to the controls, though it had not proceeded to real scoliosis. Both in 1987 and 2011, rates of physical complaints did not differ between patients and controls. Prosthetic use did not seem to have an influence on physical features and complaints. These results imply that prevention of physical complaints should not be a reason for prosthetic use.