Congenital Radial Club Hand Research Articles

Residual deformity in congenital radial club hands after previous centralisation of the wrist. Ulnar lengthening and correction by the Ilizarov method.

We used the Ilizarov method in seven patients with severe congenital radial club hands who had had previous wrist surgery, to correct residual shortening and bowing of the ulna together with recurrent wrist deformity. The mean age at operation was 6.5 years. The mean ulnar shortening was 5.3 cm and the mean angular deformity 42 degrees. The mean length gained was 51% of the original ulna. The mean healing index was 46.9 days (29.8 to 64.0). The ratio of the length of the lengthened ulna to the normal side improved on average from 64% to 95%. The angular deformity was initially completely corrected in six out of seven patients. The length ratio, however, decreased to 83% at the final follow-up. In four patients, the angular deformity partially recurred. We recommend correction of congenital radial club hand by staged procedures. The first is centralisation and stabilisation of the wrist and the second lengthening of the ulna and correction of the angular deformity using the Ilizarov method.

VASCULARIZED BONE GRAFTS TO THE UPPER EXTREMITY

Massive autogenous bone grafts with an intact vascular pedicle decrease the time to bony union and immobilization required for treatment of segmental bony defects. These techniques have been shown to be effective in treatment of segmental defects of more than 6 cm after trauma or tumor resection in relatively avascular beds. Additionally, in the upper extremity, the free vascularized bone graft is in the developmental phase for employment in the reconstruction of epiphyseal arrest and congenital radial club hand. There are disadvantages to free vascularized bone transfers compared with conventional techniques. For example, a free vascularized fibular transfer requires a team skilled in microvascular technique, a long operative time (6 to 10 hours), and the sacrifice of a major vessel to the lower extremity. If the anastomosis fails, however, the free vascularized fibula will act as a conventional bone graft, thereby minimizing adverse effects. We think that by proper patient selection, appropriate evaluation and preparation of the bony defect, meticulous microvascular anastomosis, and correct fixation and immobilization of the graft a good outcome can be achieved in those patients with large bony defects that defy the use of conventional methods.

Operative treatment of the radial club hand

Eight patients with twelve congenital radial club hand deformities were treated by two different surgical methods. One of them was centralization of the ulna into the carpus and the transpozition of the flexor and extansor carpi radialis tendons to the ulnar side. The other surgical method was radialization. Pollicization of the index finger was done on five occasions. The patient s ages at the time of surgery ranged from 1 to 14 years (average of 4 years and 2 months). The average post operative follow-up was 3.5 years. The follow-up examinations have shown remarkable improvement of function and appearance in the eleven of the 12 radial club hand deformities exception for one case.

Axillary Block for Vascular Insufficiency after Repair of Radial Club Hands in an Infant

Vascular insufficiency may occur after a variety of surgical procedures and has been described after repair of congenital radial club hand. Treatment of vascular insufficiency by use of sympathectomy has recently been reported in the pediatric population. We describe successful use of bilateral axillary blocks to relieve acute vascular insufficiency in a 7-month-old infant after surgical repair of radial club hands

Treatment of congenital radial club hand : D. Define. Clin. Orthop. 73:153–159 (November–December) 1970

Treatment of congenital radial club hand : D. Define. Clin. Orthop. 73:153–159 (November–December) 1970

Treatment of Congenital Radial Club Hand

Treatment of Congenital Radial Club Hand