Functional outcomes following single-event multilevel surgery of the upper extremity for children with hemiplegic cerebral palsy.

Background: Outcomes following single-event multilevel surgery of the upper extremity for children with cerebral palsy have not been well described in the literature. Since 1996, all children with hemiplegic cerebral palsy at our institution thought to be candidates for upper extremity surgery have had serial Shriners Hospital for Children Upper Extremity Evaluation performed for both clinical decision making and outcome assessment. The goal of the current study was to determine the functional outcomes, as described by the Shriners Hospital for Children Upper Extremity Evaluation, following single-event multilevel surgery of the upper extremity in children with hemiplegic cerebral palsy.

Surgical management of thumb deformity in children with hemiplegic-type cerebral palsy.

Background: Evidence-based clinical decision-making for the surgical management of thumb deformities in children with cerebral palsy is difficult, primarily because of a lack of consensus with respect to assessment of thumb alignment and function. We have used the Shriners Hospital Upper Extremity Evaluation, a validated assessment tool, to determine the outcome after thumb reconstruction surgery in these children. The goals of this study were to determine the relationship between static and dynamic assessments of the thumb before surgery, the outcomes with respect to static and dynamic alignments of the thumb after soft tissue and skeletal surgery, and the relationship between preoperative spontaneous functional use of the involved extremity (indicative of the magnitude of neurologic impairment) and the change in thumb dynamic alignment after surgery.

Validation of the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) for children with hemiplegic cerebral palsy.

Background: The Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) is a video-based tool for the assessment of upper extremity function in children with hemiplegic cerebral palsy. This tool includes spontaneous functional analysis and dynamic positional analysis and assesses the ability to perform grasp and release. The purpose of the present study was to assess the reliability, concurrent validity, and construct validity of this instrument.