{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:14:30Z","timestamp":1753892070680,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Camptodactyly, clasped thumbs, and windblown hands are distinctive features of distal arthrogryposis (DA). Current therapeutic interventions often yield suboptimal effects, predisposing patients to relapses and complications. This study explicates a corrective approach involving a progressive extension brace for the management of DA and evaluates its clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2015 and 2023, progressive extension braces were used in 32 DA patients, with an average follow-up of 4.8 years. Patients were stratified by age into four groups: 0\u20131, 1\u20133, 3\u20137, and above 7 years. The correction of camptodactyly was assessed based on the total active movement (TAM) of metacarpophalangeal joints (MPJ) and proximal interphalangeal joints (PIPJ), as well as the extensor lag of PIPJ. Clasped thumb correction was evaluated by measuring the thumb-to-index finger metacarpal angle (M1M2 angle) and the degree of deviation at the first MPJ (M1P1 angle). The quality of life for the children was measured using PedsQL 4.0, while parental satisfaction was gauged using the FACE questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Earlier intervention with a progressive extension brace yielded superior corrective results. Infants aged 0\u20131\u2005year and toddlers aged 1\u20133\u2005years achieved average TAM scores of 152\u00b0 and 126\u00b0 after correction; however, patients older than 3 years experienced a significant decrease in TAM with the same treatment. Infants and toddlers with DA showed improvement in the average extensor lag from 46\u00b0 to 6\u00b0. The M1M2 angle increased from an average of 38\u00b0 to 65\u00b0, with the M1P1 angle decreasing from an average of 43\u00b0 to 5\u00b0. After the treatment, average PedsQL scores of 94.7 (parent-reported) and 89.3 (child-reported) were achieved. Among the 32 parents, 24 expressed high satisfaction, 5 expressed moderate satisfaction, and 3 expressed fair satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The early, progressive, and consistent use of an extension brace significantly improved joint mobility and corrected camptodactyly and clasped thumbs. It can be an effective approach to addressing hand deformities in patients with DA.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1385938","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:31:50Z","timestamp":1714365110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A retrospective study on the correction of distal arthrogryposis with a progressive extension brace"],"prefix":"10.3389","volume":"12","author":[{"given":"Jiateng","family":"Zhou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhibo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongdong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qinyuan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1002\/(sici)1096-8628(19961111)65:4%3C277::Aid-ajmg6%3E3.0.Co;2-m","article-title":"A revised and extended classification of the distal arthrogryposes","volume":"65","author":"Bamshad","year":"1996","journal-title":"Am J Med Genet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1002\/ajmg.c.31716","article-title":"Classification of arthrogryposis","volume":"181","author":"Hall","year":"2019","journal-title":"Am J Med Genet C Semin Med Genet"},{"volume-title":"Causes, consequences and clinical course in amyoplasia and distal arthrogryposis","year":"2009","author":"Kimber","key":"B3"},{"key":"B4","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.jhsa.2021.10.027","article-title":"The hand in distal arthrogryposis","volume":"47","author":"Alzahrani","year":"2022","journal-title":"J Hand Surg Am"},{"key":"B5","doi-asserted-by":"publisher","first-page":"874.e1","DOI":"10.1016\/j.jhsa.2018.03.023","article-title":"Camptodactyly treatment for the lesser digits","volume":"43","author":"Wall","year":"2018","journal-title":"J Hand Surg Am"},{"key":"B6","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.rboe.2014.03.002","article-title":"Evaluation of treatment for camptodactyly: retrospective analysis on 40 fingers","volume":"49","author":"Almeida","year":"2014","journal-title":"Rev Bras Ortop"},{"key":"B7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.hcl.2017.12.013","article-title":"Treating congenital proximal interphalangeal joint contracture","volume":"34","author":"Yannascoli","year":"2018","journal-title":"Hand Clin"},{"key":"B8","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1097\/01241398-198505000-00004","article-title":"Surgical management of arthrogryposis in the upper extremity","volume":"5","author":"Bennett","year":"1985","journal-title":"J Pediatr Orthop"},{"key":"B9","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1097\/01241398-198409000-00014","article-title":"Arthrogryposis of the hand","volume":"4","author":"Yonenobu","year":"1984","journal-title":"J Pediatr Orthop"},{"key":"B10","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1002\/ajmg.a.36395","article-title":"Amyoplasia revisited","author":"Hall","year":"2014","journal-title":"Am J Med Genet A"},{"key":"B11","doi-asserted-by":"publisher","first-page":"40","DOI":"10.2106\/jbjs.I.00281","article-title":"Arthrogryposis: a review and update","volume":"91","author":"Bamshad","year":"2009","journal-title":"J Bone Joint Surg Am"},{"key":"B12","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1097\/bpo.0000000000000997","article-title":"Genetics and classifications","volume":"37","author":"Hall","year":"2017","journal-title":"J Pediatr Orthop"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1177\/17531934221101998","article-title":"Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita","volume":"47","author":"Anbarasan","year":"2022","journal-title":"J Hand Surg Eur"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1748","DOI":"10.1016\/j.jhsa.2015.04.031","article-title":"The use of an hourglass dorsal advancement flap without skin graft for congenital syndactyly","volume":"40","author":"Ni","year":"2015","journal-title":"J Hand Surg Am"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1016\/j.bjps.2022.01.020","article-title":"Aggressive paediatric camptodactyly: the evolution of a proposed treatment algorithm","volume":"75","author":"Miranda","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1097\/bth.0000000000000059","article-title":"Reorientation osteotomy for the atypical clasp thumb in children with arthrogryposis","volume":"18","author":"Zlotolow","year":"2014","journal-title":"Tech Hand Up Extrem Surg"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1385938\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:31:53Z","timestamp":1714365113000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1385938\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,29]]},"references-count":16,"alternative-id":["10.3389\/fped.2024.1385938"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1385938","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2024,4,29]]},"article-number":"1385938"}}