Evaluating Outcome of Surgical Centralization for Radial Club Hand in Children

Abstract

Background: Various types of osteotomy have been proposed to treat Radial club hand. We reviewed the results of Ulnar osteotomy, Centralization, and tendon transfer. Methods: Between 2000 and 2011, we treated 32 cases of Radial club hand with two Variants Variation 1 (n= 23): ulnar osteotomy; Variation 2 (n=9): without osteotomy; There were 23 patients. Male 10 and Female: 13. Unilateral: 14. Bilateral: 9. Mean age at Operation: 33 months and Follow Up: 56 months. We compared Wrist-Forearm, Hand-Forearm angles before and after surgery, range of motion for all patients. Results: Surgical Centralization on all patients, and Ulnar Osteotomy on 23 forearms. The Patients was Operated according to separated two Variants; there were 23 Variant 1, mean Ulnar bow: 38.68° ±3.583 (33.6° – 45.2°); and there were 9 Variant 2. mean Ulnar bow: 28.15° ± 3.176 (25.7°—28.4°)without ulnar osteotomy. There were 14 patients with unilateral: 8 (57.1%) in V1, and 6 (42.9%) in V2. There were 9 patients with bilateral (18 radial club hand): 15 (83.3%) in V1, and 3 (16.7%) in V2. Compared results on V1 and V 2 with P-values are not significant. Conclusion: Centralization and Ulnar osteotomy technique for operative treatment of the radial club hand is presented. The improved mechanical forces are further stabilized by transposition of the radial wrist extensor and flexor; this favors a better muscle balance.