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Clin Orthop Surg. 2012 Mar;4(1):36-44. doi: 10.4055/cios.2012.4.1.36. Epub 2012 Feb 20.

Changing paradigms in the treatment of radial club hand: microvascular joint transfer for correction of radial deviation and preservation of long-term growth.

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  • 1Division of Plastic Surgery & Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

Radial longitudinal deficiency, also known as radial club hand, is a congenital deformity of the upper extremity which can present with a spectrum of upper limb deficiencies. The typical hand and forearm deformity in such cases consists of significant forearm shortening, radial deviation of the wrist and hypoplasia or absence of a thumb. Treatment goals focus on the creation of stable centralized and functionally hand, maintenance of a mobile and stable wrist and preservation of longitudinal forearm growth. Historically centralization procedures have been the most common treatment method for this condition; unfortunately centralization procedures are associated with a high recurrence rate and have the potential for injury to the distal ulnar physis resulting in a further decrease in forearm growth. Here we advocate for the use of a vascularized second metatarsophalangeal joint transfer for stabilization of the carpus and prevention of recurrent radial deformity and subluxation of the wrist. This technique was originally described by the senior author in 1992 and he has subsequently been performed in 24 cases with an average of 11-year follow-up. In this paper we present an overview of the technique and review the expected outcomes for this method of treatment of radial longitudinal deficiency.

KEYWORDS:

MTP-joint transfer; Microvascular joint transplantation; Radial club hand; Radial longitudinal deficiency; Treatment

PMID:
22379554
[PubMed - indexed for MEDLINE]
PMCID:
PMC3288493
Free PMC Article
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