Radial club hand treated with soft-tissue distraction and subsequent pin stabilization: mid- to long-term results

Pfister, Georges; Hanneur, Malo Le; Bachy, Manon; Fitoussi, Franck

doi:10.1177/1753193420916694

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Pfister et al [ 22 ] retrospectively examined 31 hands in 28 patients who underwent progressive distraction and subsequent percutaneous pinning of the wrist with a corrective ulnar osteotomy. The HFA decreased from 64° to 12° after a mean follow-up of 7 years (range from 2 to 20).…”

Section: Discussionmentioning

confidence: 99%

Radial Club Hand Treated by Paley Ulnarization Generation 3: Is This the New Centralization?

Deszczyński

Albrewczyński²,

Shannon³

et al. 2021

Children

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(1) Background: Patients treated with the two previous generations of ulnarization developed a bump related to the ulnar head becoming prominent on the radial side of the hand. To finally remedy this problem, a third generation of ulnarization was developed to keep the ulnar head contained. While still ulnar to the wrist center, the center of the wrist remains ulnar to the ulnar head, with the ulnar head articulating directly with the trapezoid and when present the trapezium. (2) Methods: Between 2019 and 2021, 22 radial club hands in 17 patients were surgically corrected with this modified version of ulnarization. (3) Results: In all 17 patients, the mean HFA (hand–forearm-angle) correction was 68.5° (range 12.2°–88.7°). The mean ulna growth was 1.3 cm per year (range 0.2–2 cm). There were no recurrent radial deviation deformities more than 15° of the HFA. (4) Conclusions: This new version of ulnarization may solve the problem of the ulna growing past the carpus creating a prominent ulnar bump. The results presented are preliminary but promising. Longer-term follow-up is needed to fully evaluate this procedure.

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Section: Discussionmentioning

confidence: 99%

Radial Club Hand Treated by Paley Ulnarization Generation 3: Is This the New Centralization?

Deszczyński

Albrewczyński²,

Shannon³

et al. 2021

Children

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“…This issue gave rise to the use of soft tissue distraction (SD) before either a radialization or modified centralization procedure (Figure 4) (Goldfarb et al., 2006a; Kanojia et al., 2008; Kessler, 1989; Matsuno et al., 2006; McCarthy et al., 2009; Tonkin and Nanchahal, 1995). Time has shown that SD is of benefit before a skeletal operation (Farr et al., 2012; Goldfarb et al., 2006a; Manske et al., 2014; Murphy et al., 2017; Pfister et al., 2020; Scheider and Farr, 2022; Taghinia et al., 2007).…”

Section: Treatment Optionsmentioning

confidence: 99%

The unsolved problem of radial longitudinal dysplasia: how can we reliably prevent recurrence, preserve growth and optimize function?

Nieuwenhoven

Mann

Hülsemann

2023

J Hand Surg Eur Vol

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Congenital radial longitudinal dysplasia remains an ‘unsolved problem' in hand surgery. The challenges presented by the skeletal deficiency of the distal radius and soft tissue dysplasia of the severe radial longitudinal deficiency have been addressed by a number of techniques that aim to stabilize the position of the hand relative to the forearm and optimize forearm growth and hand function. Analysis of hand function and position in these children is difficult because of the abnormal ‘wrist' mechanics, and the published results of the techniques used to date often lack a standardized approach and importantly the perception of function from the patient's perspective. The existing data is reviewed and compared with the results of cohorts from two major congenital upper limb centres. Soft tissue distraction prior to radialization or centralization may offer benefit in ulnar growth and forearm length but there is a need for further research into the long-term functional outcomes of the various techniques available to determine the optimal choice for these children. Level of evidence: V

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“…Various authors have recently advocated for alternative techniques to centralization and radialization, including soft-tissue distraction followed by ulnometacarpal intramedullary pin stabilization 37 , ulnar metaphyseal osteotomy along with additional tendon-balancing techniques 38 , and vascularized second metatarsophalangeal joint transfer for radial support 39 .…”

Section: Treatment and Operative Techniquementioning

confidence: 99%

Congenital Upper-Limb Differences

Shah,

Bohn,

Van Heest

et al. 2023

Journal of Bone and Joint Surgery

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➤ The Oberg-Manske-Tonkin (OMT) classification of congenital hand and upper-limb anomalies continues to be refined as our understanding of the genetic and embryonic etiology of limb anomalies improves.➤ We have conducted an evaluation of graft and graftless techniques for syndactyly reconstruction; strengths and drawbacks exist for each technique.➤ Treatment for radial longitudinal deficiency remains controversial; however, radialization has shown promise in early follow-up for severe deformities.➤ Recent emphasis on psychosocial aspects of care has demonstrated that children with congenital upper-limb differences demonstrate good peer relationships and marked adaptability.

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Radial club hand treated with soft-tissue distraction and subsequent pin stabilization: mid- to long-term results

Cited by 5 publications

References 19 publications

Radial Club Hand Treated by Paley Ulnarization Generation 3: Is This the New Centralization?

Radial Club Hand Treated by Paley Ulnarization Generation 3: Is This the New Centralization?

The unsolved problem of radial longitudinal dysplasia: how can we reliably prevent recurrence, preserve growth and optimize function?

Congenital Upper-Limb Differences

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