curved forearm(radial club hand)
It is a congenital (present at birth) hand deformity where the radius bone in the forearm is missing or underdeveloped, causing the hand to be bent laterally (radially deviated). Soft tissue, bones and underlying muscle (Radius, radial carpus, thumb, tendons, ligaments, muscles, nerves and blood vessels) can all be involved.
- Small or absent thumb.
- Lateral (radial) deviation of the hand.
- Short forearm with reduced passive wrist motion.
- Lateral skin deficiency with relative excess on the medial side.
- Flexion contracture and stiffness of the radial digits.
Based on age, severity and degree of functional deficit, surgery usually performed around 12 months. Physiotherapy and splintage should start few weeks after birth Surgical procedures are centralisation/ radialisation of hand Reconstruction of thumb by shortening and rotating the index finger (pollicization) and reconstruction of deficient tendons and ligament (UCL, FPL, EPL etc.)
Usually surgery is performed at 1 years when thumb function is developing but splintage and physiotherapy should start few weeks after birth.
It depends on deformaty, stage reconstruction (pollicisation and radial structure reconstruction) is required; however few touch up procedures can be required later on.
Two to three hours, it depends on thumb deformaty.
In patient is required for the procedure and usually patient admits for one to two days.
It can be isolated or can be syndromic Holt–Oram syndrome … Cardiac septal defects and various upper limb malformations VACTERL association…Vertebral anomalies, Anal atresia, Cardiac defects, Tracheal anomalies, Esophageal atresia, Renal and radial abnormalities, other Limb abnormalities, TAR syndrome … Thrombocytopaenia, Absent Radius Fanconi’s anaemia …bone marrow failure. – Radial deficiency,aplastic anaemia.
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