Radial Club Hand | Hand Surgery | Hand Deformity - MediAngels.com




The incidence of radial club hand is estimated to be 1 in 30,000 to 1 in 100,000 live births. It is bilateral in 38% to 58% of cases.


The goal of treatment is to achieve an acceptable cosmetic and functional result. This entails correction of the wrist deformity to achieve a stable and mobile wrist joint. Also longitudinal growth capacity of the ulna should be preserved.

 A variety of treatment protocols have been described for the treatment of congenital radial club hand: centralization, radialization, and microvascular epiphyseal transfer1 in younger children and distraction osteogenesis of the ulna in the older child, especially with recurrent deformity or neglected cases.

 While one-stage procedures subject the patient to a single operation, they are associated with the possible need for carpal resections, ulnar shortening, and sacrifice of the distal ulnar growth plate, stretch injury to the radial neurovascular structures, excessive swelling of the hand, and wound complications.

Soft tissue distraction preceding centralization for congenital radial deficiency is a new method. Simple monolateral fixators, Ilizarov apparatus and Taylor spatial frame are some of the techniques available for achieving soft tissue distraction.

Pollicization is usually done my age 9 months.
  Figure 1
  Figure 2: Radial club hand is also known as pre-axial longitudinal deficiency and is characterized by complete or partial absence of the radius bone. The thumb is usually hypoplastic.
  Figure 3: Radial club hand with partial absence of radius bone.
  Figure 4: Reconstructive surgery comprises centralization of carpus followed by pollicization to restore hand function.


Deformity includes significant shortening of the forearm, and generalized underdevelopment of the extremity. The thumb is usually absent or hypoplastic and the ulna is typically 60% of normal length and bowed due to the absence of radius.

The radial deformity varies from complete absence to only shortening which may even go unnoticed.

40% of cases may have associated thrombocytopenia and anaemia.
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