Functional Benefits of Multisite Upper Limb Surgery in Children With Unilateral Cerebral Palsy (RETRO-CHIRc)

NCT07891078 | Recruiting

• 1 other identifier: 2026_04_RETROCHIRC_RNIPH
• Study Type: observational
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective study evaluates the functional impact of individualized multisite neuro-orthopedic upper limb surgery in children with unilateral cerebral palsy (hemiplegic CP). Using a before-and-after design in which each patient serves as their own control, the study analyzes data collected in routine clinical care up to 3-5 years before and 1-2 years after surgery. The primary outcome is upper limb function as measured by the Modified Melbourne Assessment (MA2), which assesses range of motion and dexterity. Secondary outcomes include unimanual precision and fluidity (MA2), global manual dexterity (Box and Block Test), bimanual performance (Assisting Hand Assessment), and patient/parent satisfaction. Approximately 70 patients operated at the Centre Médico-Chirurgical de Réadaptation des Massues between January 2012 and June 2025 will be included. The study also aims to identify factors influencing surgical outcomes, such as age at surgery, associated cognitive or sensory impairments, and adherence to post-operative orthotic protocols.

Conditions

Cerebral Palsy; Hemiplegia

Keywords

Cerebral Palsy; Unilateral cerebral palsy; Hemiplegia; Upper limb surgery; Multisite neuro-orthopedic surgery; Melbourne Assessment; Assisting Hand Assessment; Pediatric rehabilitation; Functional outcomes

Outcome Measures

Primary Outcomes (1)

• Upper Limb Range of Motion and Dexterity - Modified Melbourne Assessment (MA2)

  Scores for the "Range of Motion" and "Dexterity" dimensions of the Modified Melbourne Assessment version 2 (MA2). The MA2 evaluates unilateral upper limb quality of function during tasks involving object approach, grasp, release, and manipulation in children aged 2.5 to 15 years with neurological impairment. Assessment is video-recorded during routine clinical care and scored retrospectively by an occupational therapist. Results are expressed as percentages for each of the four MA2 domains. Inter-rater reliability is excellent (R=0.95) and intra-rater reliability is very good (R=0.97).

  Data collected retrospectively up to 3 years (or 5 years if available) before surgery and up to 1 year (or 2 years if available) after surgery.

Secondary Outcomes (11)

• Unimanual Precision and Fluidity - Modified Melbourne Assessment (MA2)

  Data collected retrospectively up to 3 years (or 5 years if available) before surgery and up to 1 year (or 2 years if available) after surgery.

• Global Manual Dexterity - Box and Block Test (BBT)

  Data collected retrospectively up to 3 years (or 5 years if available) before surgery and up to 1 year (or 2 years if available) after surgery.

• Bimanual Performance - Assisting Hand Assessment (AHA)

  Data collected retrospectively up to 3 years (or 5 years if available) before surgery and up to 1 year (or 2 years if available) after surgery.

• Patient and Parent Satisfaction with Surgical Outcomes - Goal Attainment

  Postoperative assessment, between 12 and 36 months after surgery

• Overall Patient and Parent Satisfaction with Surgical Treatment

  minimum 12 months post-surgery, assessed through study completion

Study Arms (1)

Children with Unilateral Cerebral Palsy - Multisite Upper Limb Surgery

Retrospective cohort of children with unilateral cerebral palsy (hemiplegia) who underwent individualized multisite neuro-orthopedic upper limb surgery at the Centre des Massues between January 2012 and June 2025. Surgical procedures were individualized and may include one or more of the following: short adductor of thumb release, flexor carpi ulnaris (FCU) release, FCU transfer to extensor carpi radialis brevis, finger flexor lengthening, round pronator release, elbow flexor lengthening, wrist arthrodesis, and other procedures. All patients underwent pre-surgical multidisciplinary evaluation, specialized surgery, and structured post-operative rehabilitation including orthoses and occupational therapy.

Eligibility Criteria

• Age: Up to 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Children with unilateral cerebral palsy (hemiplegia) who underwent individualized multisite neuro-orthopedic upper limb surgery at the Centre Médico-Chirurgical de Réadaptation des Massues between January 2012 and June 2025, with available pre- and post-operative functional assessments.

You may qualify if:

• Minor patient (age \< 18 years at the time of the surgical project)
• Unilateral upper limb involvement due to Cerebral Palsy
• Having undergone neuro-orthopedic upper limb surgery
• Surgery performed by the surgeon who participated in the multidisciplinary surgical planning meeting (EMC)
• Surgery performed between January 1, 2012 and June 30, 2025
• Availability of at least one pre-operative assessment and one comparative post-operative assessment at more than 12 months after surgery
• Followed at the CMCR des Massues
• Refusal of medical data processing for research purposes

Sponsors & Collaborators

• Centre Médico-Chirurgical de Réadaptation des Massues Croix Rouge Française: lead

Study Sites (1)

Centre Médico chirurgical de Réadaptation des Massues

Lyon, 69005, France

RECRUITING

MeSH Terms

Conditions

Cerebral Palsy; Hemiplegia

Condition Hierarchy (Ancestors)

Brain Damage, Chronic; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Julie Rozaire, PhD

CONTACT

+334 72 38 11 43; julie.rozaire@croix-rouge.fr

Rachel Bard-Pondarre

CONTACT

bard.rachel@orange.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 18, 2026
• First Posted: October 23, 2026
• Study Start: July 1, 2026
• Primary Completion: September 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: October 23, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)