history

Last reviewed 01/2018

The history of the child with a congenital upper limb anomaly should encompass the following key areas:

  • age of child
  • hand dominance, if any
  • progression of deformity since birth
  • developmental hand milestones
  • previous treatments
  • family history; variable expressivity and incomplete penetrance is common and as such, a limb anomaly can skip a generation
  • history of pregnancy:
    • previous pregnancies:
      • stillbirths
      • miscarriages
      • other anomalies
    • exposure to mutagens:
      • viral infections
      • drug exposure
    • duration of pregnancy in weeks
    • duration of labour
    • position of baby at time of birth eg breech
    • posture of the affected limb at the time of delivery
  • general health:
    • syndromes
    • co-morbidities eg cardiac, respiratory or renal disease
    • developmental milestones
    • medications
    • allergies
  • how the family are coping with the diagnosis:
    • psychologically
    • physically eg existing orthotic devices or home adaptation