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34 Rehabilitation in Congenital Hand and Forearm Defects: Rehabilitation of the Child’s Hand—General…
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Disposition is chosen in order to avoid intrinsic
muscle retraction.
Sometimes the surgeon chooses the pull-out
technique, this can allow immediate mobilization, and the little patient will have of course a
limit in the maximum open extension. The splint
is going to be removable from the very beginning
and will be made in the same position that we
explained before in order to protect the suture of
the tendon.
The weaning of the splint will take a little bit
longer for your patients, especially during the
night and in risky situations.
The recovery will be placed basically on playing; the therapist will choose with the little
patient games and toys that can be appropriate for
the situation and the age.
Fortunately in children the elasticity of the tissues helps to reduce the post-immobilization
stiffness.
The massage of the scar will be extremely
Image 34.66 Splint for extensor lesion
important and has to be done more than four
times a day, not very long but very often during
the day. The technique of the massage is to do it
slowly with pressure in order to avoid a thickening of the scar and to limit the establishment of
adherence in the deep tissues.
Another tool that needs to be associated with
the massage is the use of silicon sheets, to wear
during the night, that means for at least 8h per
night. It is very important to spend some time
during the rehabilitation process paying attention
on the recovery of sensibility on the scar and
nearby areas; this can be done with the stimulation of the part with different tissues from the
softer to the rougher.
In case of stiffness after 8 weeks it will be possible to make dynamic splint to increase the
mobility of the single nger or of more of them.
During the tenth week, the therapist can try to
use electrostimulation in order to promote the
sliding of the tendons and reduce the possibility
of adherence, and for biofeedback.
At about 12 weeks if there are no decits the
patient can go back to normal activities and use
the whole limb like the other.
Also in extensor tendon lesion the therapeutic
approach should be performed cautiously.
Normally the time of immobilization is of 6
weeks with a splint in extension of the ngers
and wrist in a neutral position (Image 34.66).
At the end of the sixth week we start to move
the little hand of the child, making a removable
splint. The therapist will teach the little patient
and parents some exercises for the ngers like the
“hook” and the “roof,” so gradually as the exion
improves the patient will be able to do a complete
st. To help the patient to understand how to
close the hand the therapist will provide some
targets, like cylinders from bigger ones to smaller
ones. During the rehabilitative session different
kinds of grips will be offered to the child in order
to recorticalize the correct gesture of the single
hand, and of both in bimanual grips.
For sure also in this case the treatment of this
scar when healed will be very important, and will
follow the rules that we have explained before
such as multiple massages during the day and the
use of silicon sheets during the night. The extensor tendons slide immediately under the skin; this
means that normally a scar has more possibility
to do adherence with the next tissues and this can
limit the range of motion. This is why the parents
need to learn from the therapist how to do
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E. M. Mancon et al.
dynamic sliding: this means they x the skin in
one way and they asked the child to extend or ex
the schools a double effect on the scar and can be
very useful. Also in this case during the week if
there is stiffness the therapist can make dynamic
splint in exion to increase the range of motion.
At about 12 weeks like for exor tendons, the
rehabilitative protocol ends if the patient do not
present any decit, and normal activity is
permitted.
Association toSupport Babies
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andFamilies
AmyLake, MartinaPajardi, andElenaM.Mancon
35
Abstract
The concept of therapeutic camps for children
with chronic conditions has been around since
the 1970s and proven to provide psychosocial
interventions to help decrease the burden of
disease and provide support, respite, and skill
building through recreational activities for
diagnoses such as spina bida, epilepsy, pediatric cardiac conditions, and cancer (Bar etal.,
J Pediatr Hematol Oncol 32:358–365, 2010;
Holbein etal., J Pediatr Psychol 38:412, 2013;
Sawin etal., J Neurosci Nurs 33:57–64, 2001;
Bultas etal., J Spec Pediatr Nurs 8:320–328,
2013).
Congenital anomalies of the hand and
upper limb which can affect function, social
interactions, and self-condence (Lake, Tech
Hand Up Extrem Surg 14:78–84, 2010) is a
new diagnosis beneting from the concept of
camp. This need was observed by Texas
Scottish Rite Hospital, a specialty orthopedic
A. Lake (*)
Department of Upper Extremity and Microsurgery,
Scottish Rite Hospital for Children,
Dallas, TX, USA
Department of Hand Surgery and Rehabilitation,
San Giuseppe Hospital IRCCS MultiMedica,
University of Milan, Milan, Italy
e-mail: amy.lake@tsrh.org
M. Pajardi · E. M. Mancon
Department of Hand Surgery and Rehabilitation,
San Giuseppe Hospital IRCCS MultiMedica,
University of Milan, Milan, Italy
e-mail: elenamarta.mancon@multimedica.it
hospital, in 1995. At that time, a Hand Camp
model was developed and has evolved and
expanded through the years. This model was
studied in 2015 which generated a publication. The impact of therapeutic camp on children with congenital hand differences (Lake,
Cogent Psychol 8:1, 2021) shows an increase
in the areas of self-esteem, physical function,
activity participation, and peer relations.
Hand Camp offers children born with a
congenital hand difference the opportunity to
learn from other peers and counselors with
similar hand differences on how to navigate
through everyday life. From putting hair up
into a pony tail or painting ngernails, to tying
shoes and throwing a baseball, each child can
learn new skills from individuals with the
same exact hand difference. This connection
builds self-esteem while also improving physical functioning and ultimately allowing children to be accepted by who they are on the
inside instead of dened by what the look like
on the outside.
Keywords
Camp · Hand differences · Congenital hand
differences · Hand camp · Pediatric hand
therapy
The birth of a child brings positive emotions of
joy and happiness, but if this event is conjoined
with the diagnosis of a congenital malformation
© Springer Nature Switzerland AG 2023
G. Pajardi (ed.), Pediatric Hand Surgery, https://doi.org/10.1007/978-3-031-30984-7_35
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A. Lake et al.
sometimes associated with a syndrome, families
may live this moment with anxiety, worry, and
fear.
The pathologies and malformations involving
a child inevitably represent both a familial and
social issue, at rst micro-social issue referring to
the environment surrounding the family’s daily
life and then tackling the sometimes harsh
encounter with society.
The network of relationships that will be created around the newborn will be essential until
the rational and conscious social comparisons
occur. The newborn will not appreciate that he is
special and just born this way initially however
will benet from the invaluable network made up
of family, relatives and friends who are able to
support the parents and child, who are at the
beginning of both an amazing and complicated
journey.
The network then expands with the rst medical and specialist visits. The medical component
provides all-around care, with an entire team
dedicated to the patient and his family, and is
composed of highly specialized gures: the surgeon, the pediatrician, the pediatric nurse, the
pediatric anesthesiologist, the physiotherapist,
the neuro- and psychomotility therapist, and the
psychologist.
The presence of a supportive network that works
as an exchange of information and contacts among
the families, can be a positive framework of specialist that can decreased anxiety, confusion and doubts.
Today in Italy, there are different associations that
are involved with children affected by upper limb
malformations. One example is DEBRA Italia
Onlus, an association that deals with epidermolysis
bullosa congenita, a serious systematic malformation that affects the invalidating limbs, and another
example is the Italian Association of POLAND
Syndrome, which is concerned with children
touched by this syndrome.
Other malformations strictly involve the upper
limb or just the hand and therefore are not part of
a syndromic picture; in recent times, more associations such as the Macrodactylia National
Association founded on 16 December 2017 have
been created to unite children affected by macrodactyly and their families.
Other times the malformative frameworks are
so rare or diversied that many families nd themselves alone when the affected child is born, lacking adequate health information and time
guidelines on when to go to specialists and without
knowledge about regional permits, reimbursements, or anything else that involves the household. Parents suddenly nd themselves in a new
life that is inevitably changed, because of the birth
of a new child and the added challenges and difculties that this beautiful moment will bring them.
Most of the children followed by our department present malformation patterns that involve
solely the hand or upper limb, without there
being signs of a systemic syndrome or of pathologies related to the entire organism. These have
evoked such great interest in the past couple of
years that an entire association was created to
unite and represent them. In 2008, thanks to its
President Elisabetta Palleroni Pajardi, the La
Mano del Bambino Association was founded, an
association that helps families share experiences,
ashes of daily life, and health information.
“The Child’s Hand Association purpose is to
create scholarships or nancial aid for individuals or organizations that will then begin a specic
activity working towards the same goal, and creating regulations to ensure the funding.
It will promote courses or will follow meetings and conferences about the hand and the
upper limb, having the ability to range from medical students or similar specialties, to physiotherapists and occupational therapists who are
pursuing degrees and courses of various levels
and formalities, but whose validity is shown
through the structure of the organization and the
quality of the speakers and participants. It also
works to help and collaborate with professionals
of all backgrounds whose work is in synergy to
that of the association.
It will work to promote the circulation of
information and publicity at every level, journalistic, television, with participation in debates,
seminars, and meetings of all kinds both at the
associative level and on behalf of the individual
components with special reference to occasions
that might have wide cognitive emphasis to the
user level.
35 Association toSupport Babies andFamilies
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477
Specically, its aim is to inform the medical
and paramedical eld on the one hand, and the
population on the other, on what the main pathological events concerning the upper limb may be
and the consequent remedies, with particular
attention to the preventive moment, as well as
traumatic events or arthritic-degenerative pathologies, working to ensure that a more correct
social medicine and preventive hygiene can protect the hand as a fundamental organ of family
life, work, and relationship.”
At the World Conference on Malformations
held in Dallas in 2012 and chaired by Elisabeth
Ezaki, Professor Pajardi’s staff learned about the
arrangement of the campus, implemented in that
reality and which is discussed in an extremely
comprehensive way in the rst part of this chapter. Wanting to adapt this initiative to the sensitivity and the Italian mentality, Professor Pajardi,
together with his wife Elisabetta, created the rst
Italian Campus dedicated to the Child’s Hand on
22 September 2012. As guests of the Good
Shepherd Foundation led by Sister Cristina
(Maria Luisa Triulzi), families were given a
moment of meeting and confrontation with others that allowed children to live a nonclinical
experience of play and entertainment and parents
to compare the health journeys that they are going
through, deriving benets and reassurance in a
way that is more effective than by solely comparing themselves with the health world.
The campus therefore sees two different
moments that take place in parallel throughout
the day. During the morning, there are a series of
lectures by the surgeon, the anesthesiologist, the
rehabilitation therapist, and the psychologist
whereas in the afternoon, moments of dialogue
and confrontation with families with the
“question- answer” approach. In parallel to this,
the children are involved in moments of play
organized by volunteers and members of the
association and the department, in which both the
group and individual activities are divided by age
group and that are frequently focused on the use
of hands. In these moments, there is no distinction between pathologies, and it is wonderful to
see how children affected by malformations who
are still waiting for treatment compare them-
selves with others who have already undergone
treatment and how they meet and interact with
siblings and friends who do not have these problems, perfectly integrated with no reason for difference or marginalization.
Illustrious guests from the sports, art, and
social worlds of Milan, who had been treated in
the Department of Hand Surgery of the Hospital
San Giuseppe Multimedica, always accepted to
participate during these moments of celebration
and valued the opportunity to get back to their
artistic and sports activities. They participated in
seven editions: the motorcycle champion
Bertolasio Samuele; the Olympic fencing champion Matteo Tagliariol; the marathon runner Luca
Zanardini; the Italian basketball champion Luca
Fumagalli; the European champions of Judo of
the State Forestry Group Luca Ardizio, Aldo
Scollo, and Giulio Sacchi; and the musician Alex
Battini de Barreiro.
In recent years, the Fire Brigade Corps of the
Provincial Command of Milan has been included,
thus combining a moment of recreation with one
of education, sensitizing children to their duties
of social life and relationships.
Starting from the next edition, there will also
be a time to meet with the dogs that participated
in the Hospital’s pet therapy rehabilitation
practice.
This is not the only time for family support,
though. A similar initiative called “Gazebike Pedala for La Mano del Bambino” has also been
taken in Rome, supported by the Buratti family.
Its purpose is to combine cultural experiences
such as discovering historical points in Rome
through bicycle rides, with times of information
and comparison with the population, to sensitize
people to the reality and the functional implications, although fortunately often solved, related
to children’s hands.
The Christmas Market is another activity
implemented by the association that serves to
unite all families without connotations of pathologies during the festive moment of the wait for
Christmas.
Last but not least, the Mano Del Bambino
Association has been participating in the EA7
Emporio Armani Milano Marathon since 2014,
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A. Lake et al.
which takes place on the rst Sunday of April and
sees both marathon runners and relay runners
marching through the city with banners of the
association, a visible and concrete tool for meet
people and talk about this health reality.
The dissemination of news and communication through advertising, mostly social media and
websites, is a fundamental element of information and training, two pillars of the Mano Del
Bambino Association.
It is not a forum or idle chatter but real
moments of information that anyone can access
from any place in the world, which is in point of
fact what animates the network. It should be
emphasized that to this day, 80% of children get
to the treatment department thanks to information gathered on the internet. Websites are therefore a tool of information and of testimonies that
allow those who could not attend courses and
events to gather information and to be part of the
life of the association (manobambino.org, http://
www.lachirurgiadellamano.it/it/news/
campus- le- mie- mani- 7ed- 22- sett- 2018).
Even in the digital age, radio- and telecommunication, and printing are of great support.
They are instruments related to the time they are
released, but that reach us in our home or in our
car, without us having to look for them and therefore reaching people who have not had a chance
to discover this reality.
It should be stressed that printing is not always
sensitive to these problems because speaking by
associating the terms children and illness often
“annoys” the adult and healthy population who
would rather identify themselves with diseases
that directly affect them.
Nonetheless, the primary print and television
publications have a great social sensitivity for
children’s problems and validly accept our
messages.
The common denominator between the associations and initiatives organized by them is not
fund raising, but rather to inform the families
who have the opportunity to access care, the
health workers potentially involved in the health
support of these children, and lastly the people
who may interact with those who have these
types of problems during school or work life.
The medical and rehabilitative component is
helped by the great voluntary support of the associations, especially when it comes to the relational component, as it functions as a container of
doubts, confusion, anxiety, and questions. Every
single member of this relational network, just
like many actors and characters involved in a
movie, no matter how different the roles are, will
benet from the association life because the
moments of exchange and comparison are
moments of growth for everyone.
It has been written that “camp, if it is worthy,
is one of the greatest socializing, humanizing,
civilizing factors which can enter the life of a
boy or girl” [1]. Traditional summer camps are
often unable to offer appropriate accommodations in regular camp activities for children with
chronic conditions, due to their increased needs
in medical care or physical limitations [1,
p. 361]. Unfortunately, many children with
chronic conditions are not given the opportunity
to experience the socialization benet that
attending camp may offer. Research has found
that children with chronic illnesses are at a
greater risk of experiencing psychological difculties such as behavior problems, poor selfconcept, and social withdrawal [1]. Children
with chronic conditions are estimated to have a
1.3–3 times greater risk of psychological or
social issues during childhood when compared
to a healthy child [1, p. 41]. Furthermore, a
child’s perception and attitude about their condition may mediate their development of problems, including social adjustments with peers,
coping mechanisms, and how they adapt to his/
her chronic condition [2].
In the 1970s, the concept of therapeutic camps
for children with chronic conditions was created.
This camping experience was found to provide
psychosocial interventions that helped decrease
the burden of disease and provide support,
respite, and skill building through recreational
activities [1, 3]. Many diagnosis-specic camp
models have been established and researched,
such as spina bida, epilepsy, pediatric cardiac
35 Association toSupport Babies andFamilies
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479
conditions, and cancer [4–7]. Among all of these
diagnosis-specic camps, there were several
common ndings and outcomes, such as
increased independence with activities of daily
living, decreased parent/child anxiety, and
increased self-esteem and increased social, emotional, and physical functioning [4–7].
Congenital anomalies of the hand and upper
extremity range from mild to severe and can
affect function, social interactions, and selfcondence [8]. Reaching maximum functional
independence and gaining acceptance of their
difference is the most typical goal of children
born with a hand difference. Therapy for these
children varies from structured outpatient therapy, use of orthoses or prosthetics for specic
tasks, surgical intervention, and support groups.
Eileen Bradbury found in her book, Counseling
People with Disgurement (1996), that having a
hand difference, or disgurement, can create
social avoidance within individual as well as others surrounding him/her [9]. Additionally, adolescence is naturally a time of considerable
change, with a school environment that is more
competitive and less protected. The physical
changes occurring in adolescence evoke increased
self-consciousness, which is intensied in those
with a visible difference [9].
Seeing a need within the congenital hand difference community, Texas Scottish Rite Hospital,
a specialty orthopedic hospital, developed Hand
Camp with the hope to assist this unique pediatric
population and attempt to address the concerns of
self-image, self-esteem, and condence. This
camp model has expanded and serves children
throughout stages of development from early
childhood to adolescence. These camps allow
patients and families to interact, share concerns,
and provide support for one another by engaging
in team building activities and programs.
The Camp director’s developed a Hand Camp
Mission Statement and Objectives to give structure and goal-oriented direction. These objectives
were informed by medical expertise, previous
research ndings, and observation of camp over a
25-year period to dene the purpose of camp as
well as expected outcomes following the campers’ experience.
Hand Camp Mission Statement
Hand Camp is an opportunity for children with
upper limb differences to meet others facing similar challenges. The weekend retreat for children
ages 10–13 provides a safe environment to share
experiences, challenges, fears, and successes. In
addition, camp gives children an opportunity to
focus on enhancing condence and self-esteem
through team building, exposure to new experiences, and developing leadership skills and to
help and encourage each other during goaldirected organized activities.
Hand Camp Objectives
1. Enhance self-esteem and self-condence.
2. Increase function/participation in activities
offered in their home environment.
3. Increase relationships with peers.
4. Increase self-image and acceptance of their
hand difference.
5. Increase desire to try new things without
being fearful of failure.
6. Increase independence in functional daily
activities.
7. Gain condence in explaining hand difference
to others.
8. Acquire coping skills to manage negative
reactions from others regarding their hand
difference.
Activities offered at Hand Camp consist of
high and low rope elements, archery, arts and
crafts, team building activities, time for same sex
peer-to-peer discussion/activity time, and
directed and nondirected time to work on activities of daily living.
Following camp, participants indicated
improved skills in interacting with peers, daily
physical activities, willingness to try new things,
and condence in explaining hand difference.
Meeting these camp objectives combined with
increased self-esteem (as seen through utilizing
the RSES [10] pre- and post-camp), upper
extremity functioning (as seen through utilizing
the PROMIS [11–13] both pre- and post-camps),
and peer relations (PROMIS) provided useful
skills for campers to translate into their everyday
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A. Lake et al.
life. This suggests that following camp, a child is
more apt to participate in extracurricular activities, have higher self-esteem as regards to their
hand difference, be more independent in activities of daily living, and manage negative reactions from others regarding the appearance of
their hand [14].
Since 1995, Hand Camp has been offered at
the Texas Scottish Rite Hospital for Children for
children with congenital hand difference and
their families to address physical needs as well as
psychological needs by incorporating both
aspects in the mission and objectives of camp. At
camp, kids get the opportunity to learn from other
peers and counselors with similar hand differences on how to navigate through everyday life.
From putting hair up into a pony tail or painting
ngernails to tying shoes and throwing a baseball, each child can learn new skills from individuals with the same exact hand difference. The
success that children feel when they accomplish
something they thought they would never be able
to do all by themselves is uplifting and motivating to the learner and the trainer. Our goal is that
kids leave camp with an increased self-esteem
and self-condence, a better body image, and an
increased ability to form peer relations. We hope
they leave with a greater understanding of their
diagnoses and how to explain it to others as well
as an increased desire to try new things back
home in their communities without being fearful.
Ultimately, we hope these kids leave feeling
dened by who they are on the inside instead of
by what they look like on the outside.
References
1. Barr RD, Silva A, Wong M, et al. A comparative
assessment of attendance and nonattendance at camp
trillium by children with cancer and their families:
including their utilization of health and social services. J Pediatr Hematol Oncol. 2010;32:358–65.
2. Briery BG, Rabian B. Psychosocial changes associated with participation in a pediatric summer camp. J
Pediatr Psychol. 1999;24:183–90.
3. Moola FJ, Faulkner GEJ, White L, Kirsh JA. The
psychological and social impact of camp for children
with chronic illnesses: a systematic review update.
Child. 2013;40(5):615–31.
4. Bultas MW, Budhathoki C, Balakas K.Evaluation of
child and parent outcomes after a pediatric cardiac
camp experience. J Spec Pediatr Nurs. 2013;18:320–8.
5. Holbein CE, Murray CB, Psihogios AM, et al. A
camp-based psychosocial intervention to promote
independence and social function in individuals with
spina bida: moderators of treatment effectiveness. J
Pediatr Psychol. 2013;38:412.
6. Martiniuk A, Silva M, Amylon M, etal. Camp programs for children with cancer and their families:
review of research progress over the past decade.
Pediatr Blood Cancer. 2014;61:778–87.
7. Sawin KJ, Lannon SL, Austin JK.Camp experiences
and attitudes toward epilepsy: a pilot study. J Neurosci
Nurs. 2001;33:57–64.
8. Lake A. Hand therapy for children with congenital hand differences. Tech Hand Up Extrem Surg.
2010;14:78–84.
9. Bradbury ET.Counselling people with disgurement.
Leicester: BPS Books; 1996. p.1–131.
10. Rosenberg M. Society and the adolescent selfimage. Princeton: Princeton University Press; 1965.
p.20–252.
11. DeWalt DA, Thissen D, Stucky BD, etal. PROMIS
pediatric peer relationships scale: development of a
peer relationships item bank as part of social health
measurement. Health Psychol. 2013;32:1093–103.
12. Pilkonis PA, Yu L, Dodds NE, etal. Validation of the
depression item bank from the patient-reported outcomes measurement information system (PROMIS®)
in a three-month observational study. J Psychiatr Res.
2014;56:112–9.
13. Waljee JF, Carlozzi N, Franzblau LE, etal. Applying
PROMIS to assess upper extremity function among
children with congenital hand differences. Plast
Reconstr Surg. 2015;13:200–7.
14. Lake A, Cerza SP, Butler L, Oishi S, Brown A.The
Impact of therapeutic camp on children with congenital hand differences. Cog Psychol. 2021;8:1. https://
doi.org/10.1080/23311908.2021.1938439.
Index
https://t.me/medicina_free
A
Apert syndrome, 30, 33, 64, 69, 76, 77, 191, 220, 221
Aplasia radii, 35, 55, 73, 153, 158, 159, 163, 168, 177,
379, 409
Arteriovenous, 21, 257, 261, 263, 341
Arthrogryposis, 19, 34, 44, 245–254, 409, 430, 444–446
B
Bone graft, 80, 164, 180, 191, 192, 198, 213, 228, 229,
231, 232, 380
Brachial plexus palsy sequelae, 169, 283–287, 289–297,
302, 335, 337, 383
Brachydactyly, 33–35, 76, 77, 80–83, 115, 139–147, 150,
191
Brachymetacarpia, 139–144, 146, 147
C
Camp, 478–480
Camptodactyly, 19, 49–52, 54, 55, 102, 124, 132, 430,
461
Central synpolydactyly (CSPD), 87–89, 91–93, 95, 97
Child, 2–8, 11, 18, 30, 31, 33, 35, 39, 54, 62, 71, 105,
133, 136, 140, 154, 155, 157–159, 162–165,
171, 176, 177, 180, 182, 203, 205–207, 213,
222, 229, 259, 290, 306, 337, 339, 340, 346,
353–355, 380, 382, 383, 387, 388, 394, 416,
417, 419, 421, 424–429, 431–433, 435–439,
441, 443, 447, 448, 450, 451, 454–456, 458,
459, 463, 465–470, 472–474, 476, 480
Children, 2, 6, 7, 11–14, 21, 33–36, 38, 39, 43–46, 64,
68, 69, 71, 76, 77, 80, 82, 95, 106, 109, 110,
123, 129, 135, 154, 159, 163, 169–171, 179,
180, 183, 184, 198, 220, 222, 229, 285, 287,
289, 292, 293, 296, 309–312, 323, 331, 335,
337, 345, 346, 354, 356, 367, 368, 379, 380,
415, 424–431, 433, 448, 449, 451, 453, 455,
456, 465, 466, 468–470, 472, 473, 478
Children hands, 136, 205, 320, 353–363, 367–375,
423–474
Classication, 12, 30–31, 51, 53, 60, 61, 75, 76, 88–90,
102–104, 106, 109, 113, 125–131, 139–141,
155, 156, 158, 168, 175–186, 226, 227,
235–237, 243, 245–250, 256, 257, 285, 286,
292, 297, 331, 332, 379, 380, 392–395, 400,
429, 435
Cleft hand, 73, 75, 76, 123, 125–127, 129–133, 135, 136,
191, 219
Computed tomography, 13, 18, 21–25, 132, 256, 259,
287, 358, 399
Congenital, 2, 3, 19, 21–23, 29, 35, 36, 39, 44, 45, 51,
114, 123, 125, 134, 136, 153, 157, 158,
175–177, 179, 189–192, 195, 197–199, 219,
221, 232, 245, 246, 250, 251, 256, 257, 259,
265, 377–388, 392, 398, 399, 406, 409, 475,
479
Congenital abnormality, 33
Congenital absent digit, 377, 379, 380
Congenital hand, 2–6, 8, 31, 108–110, 136, 199, 246,
358, 388
deformities, 19–21
differences, 82, 103, 110, 113, 379–382, 388, 479,
480
Congenital trigger, 21
D
Decision making, 5–7, 104, 177, 382
Diagnostic imaging approach, 21, 23
Dislocations, 315, 317, 324–326
Distraction, 77, 81, 144–147, 180, 181, 183–186,
189–192, 195, 197–199, 205–208, 210,
213–217, 378–380
E
Elbow motion limitation, 184, 292, 293
Ellis-van Creveld, 113, 220, 232
Embolization, 23, 261, 262, 381
Epidemiology, 59–60, 140–141, 168, 175, 176, 256, 331
F
Failed centralization, 205
Fasciotomy, 339, 395, 398–400, 405, 408,
409, 412
Finger amputation, 228, 332, 345
First-web contracture, 154, 410
First web deepening, 80
© Springer Nature Switzerland AG 2023
G. Pajardi (ed.), Pediatric Hand Surgery, https://doi.org/10.1007/978-3-031-30984-7
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Index
First-web release, 79, 159
Flexion contracture, 49–51, 55, 89, 91, 236, 247, 248,
252, 398
Flexion deformity, 51, 52, 89, 193, 287, 292–295, 311
Flexor tendons, 155, 160, 170, 209, 210, 236, 309–311,
319, 325, 337, 371, 375, 382, 384–386, 409,
433, 439, 472, 474
Fractures, 12–15, 18, 192, 301–303, 306, 310, 311,
315–317, 319–326, 332, 368–370, 393, 394,
428, 470
Free muscle transfer, 292, 397, 401, 408, 409
Functional limitation, 2, 44, 204, 284
H
Haemangioma, 21, 22, 24, 256, 257, 259, 265
Hand, 1–6, 8, 11, 14, 15, 19, 21, 23–25, 29, 30, 32–37,
43, 50, 55, 59–61, 63, 65, 66, 68, 69, 71, 87,
101, 113, 179, 221, 246, 252, 269–271,
278–281, 284, 302, 316, 319, 321–323, 325,
326, 331, 353, 415, 465
amputation, 82, 228, 232, 278–280, 331, 332, 335,
356, 362
anomaly, 2–4, 6, 30–32, 49, 82, 132, 232
camp, 479, 480
congenital malformation, 2, 3, 19, 123, 157, 430
deformity, 239
differences, 103, 110, 388, 479, 480
disgurement, 479
malformation, 3, 21, 32, 82, 428, 442
reconstruction, 109, 134, 203–207, 209–214,
216–218, 378, 379, 388
transplant/transplantation, 353–357, 359–363
trauma, 11, 367, 368, 370, 371, 375, 469–474
Heterologous hand transplant, 3
Hypoplasia, 19, 33, 52, 73, 74, 76, 104, 125, 153–164,
167–171, 173, 175–178, 185, 186, 190, 191,
221–223, 226, 385, 430, 435, 457–460, 462
I
Injuries, 12–15, 18, 45, 197, 301–303, 306–309, 311, 312,
316, 317, 319–321, 323–325, 331–336, 344,
347, 368, 393, 402, 403, 429, 448, 466, 470
J
Joint transfer, 180, 185, 205, 208, 209, 217, 218
L
Lengthening, 140, 144–147, 189–192, 195, 197–199
Limb discrepancy, 397, 401
M
Macrodactyly, 169, 269–273, 275, 276, 279–281, 381, 476
Magnetic resonance, 260
Metacarpal synostosis, 191, 195–197, 219–229, 231,
232
Microsurgical toe transfer, 82, 379
Microvascular reconstruction, 203–207, 209–214,
216–218, 262
Mobilisation, 198, 344
Motor image, 361, 367, 460, 469
MTP-joint graft, 205
Multiple congenital contractures, 245, 250
Multiprofessional approach, 8
N
Nerve graft, 306, 385, 386, 403, 409
Non-vascularized free phalangeal transfer, 81
O
Obstetrical brachial plexus palsy (OBPP), 283–287,
289–297, 302
Opponensplasty, 253
Ostectomy, 53, 80, 108, 118, 132, 133, 136, 140, 144,
145, 173, 180, 182, 190–192, 210, 214–216,
228–232, 273–276, 287, 288, 290, 291, 294,
296, 322, 384, 400
Outcomes, 45, 53, 80, 89, 104, 106, 109–110, 132, 172,
173, 178, 184–186, 199, 312, 331, 344–346,
354, 361, 408, 409, 411, 478, 479
Overgrowth, 261, 265, 266, 269, 271, 272, 278,
279, 347
P
Parenting stress, 4
Pediatric
dressing, 415, 416
hand, 113, 316, 319, 321–323, 325, 326, 367, 368,
370, 371, 375, 379, 415, 469–474
pathology, 2, 450
surgery, 118, 353–357, 359–363, 382, 421
therapy, 479
Penetrating lesions, 325
Perinatal compartment syndrome, 394, 408, 411
Perinatal vascular lesion, 409
Peripheral nerve, 34, 284, 302, 358
PIK3CA related overgrowth spectrum (PROS), 269, 270,
272, 281
Poland syndrome, 33, 74, 476
Pollicization, 153, 156, 157, 164, 167–173, 182, 185,
186, 205, 213, 215, 218, 231, 378–381, 420,
457–460, 462
Postaxial, 34, 36, 69, 88, 89, 114, 220
Post-operative care, 109, 212, 213, 330, 339, 340, 387,
415, 416
Post operative splinting, 55
Prosthetics, 6, 136, 190, 346, 354, 479
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