History

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