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
- previous pregnancies:
- 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
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