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Shriners Hospital for Children-Lexington, Lexington, KY, USA.
Radial clubhand is a condition that is cosmetically unappealing and functionally challenging to the patient. Management of this condition aims to achieve a straighter alignment of the hand on the forearm while maintaining a stable wrist without compromise of growth at the distal ulnar epiphysis. We have been using a 2-stage procedure to manage type 3 and 4 radial clubhand since 1993. Centralization is initially obtained by using the Ilizarov fixator in a hinged-distraction mode. Once this is achieved, the correction is secured at a second stage by pinning the carpus to the ulna. We describe in detail the technique of constructing the Ilizarov frame for this purpose.
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