Neoprene Wrist Brace for Correction of Radial Club Hand in Children

Abstract

Thermoplastic wrist orthoses have been used for some time for serial correction before surgery for radial dysplasia to realign the hand on the forearm bone. However, problems have been experienced with pressure areas, especially at the distal and proximal radial edges. Inserting padding with such a small orthosis (if made for a baby) distorts the fit. A neoprene brace has been developed that can be applied to an infant as young as 3 weeks old. Thermoplastic ulnar and radial reinforcers are used to maintain the correction. The method of construction and positioning are described. The reinforcers can be serially adjusted to achieve a neutral position at the wrist. In babies, passive correction may be easier to obtain, but in older children with soft-tissue shortening, acceptable realignment can be achieved serially and maintained until surgery is appropriate. Using neoprene avoids serious pressure problems. Neoprene is durable, washable, and accepted by this client group and their parents. It has been demonstrated that correcting the alignment of the hand improves hand function, especially in bilateral activities, and allows the child to swim and play in water while wearing it, thus enhancing the quality of life.