“Radial Club Hand Syndrome” can be defined as the medical condition in which there are deficiencies in the extremities of the pre-axial and radial side of the arms. Although the deficiencies are confined to the extremities, forearm and hand, the deficiencies may stretch to the whole of the arm. Radial club hand syndrome is usually detected by the radio graphs that are performed on the patient or by the ultrasound imaging of the affected or suspected areas.
The radial club hand has various kinds of types which need to be handled in different manners. The disease is classified as follows:
1. Type N: Isolated thumb anomaly
2. Type 0: Carpal bone deficiency
3. Type I: Short distal radius
4. Type II: Miniature hypoplastic radius
5. Type III: Absence of distal radius
6. Type IV: Radius being completely absent
7. Type V: Complete absent radius along with proximal humerus manifestations
Just like stated above the different types of radial club hand requires various kinds of treatments to be rectified most of which usually involve surgical process for rectification. The most common treatments that are applied to children suffering from this condition are:
Splinting and Stretching:
Splinting and stretching is sufficient in cases where the disease is minimalist and confined to slight abnormality of the wrist. This should be followed by regular exercise which helps in fixing the extension of the wrist and relapse of the condition can be avoided.
1. Centralization: This treatment is usually applied in the severe cases where a notch is used as a replacement in the central position. Centralization is usually done to return the normal functionality of the hand by fixing the position of the ulna. The method is accomplished by the removal of the carpal bones to adjust the ulna which is followed by the wearing of a sling for an extended period of time to hold the position of the rectified bones. Although this method may cause certain damages to the ulna, this process usually cures situations like stiff elbow which helps the patient feed on her own.
2. Radialization: Radialization is a surgical treatment in which the extensors are added to the ulna and the metacarpal is pinned to it for proper movement of the hand. Usually the ulna is overcorrected to prevent the relapse of the radial club hand syndrome.
3. Vascularized Metatarsophalangeal (MTP)-Joint Transfer: Vascularized metatarsophalangeal (MTP)-joint transfer is the method of transferring the second toe to the ulna on the radial side of the same to provide it with an extra platform which will help in the proper movement of the wrist.
These treatment processes along with the proper exercises can help the patient keep radial club hand syndrome at bay and prevent it from relapsing again in the future. At Kids Orthopedics, special attention is given to the various types of radial club hand syndrome that may occur and the treatment and management is done accordingly to achieve the best possible end result.