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Posttraumatic radial club hand.

David Ring1, Karl Prommersberger, Jesse B Jupiter

  • 1Harvard Medical School, Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA. dring@partners.org

Journal of Surgical Orthopaedic Advances
|November 24, 2004
PubMed
Summary
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This study evaluated operative treatment for unstable radius fractures with severe deformity. All patients achieved functional hand alignment and use after surgical intervention.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Traumatology

Background:

  • Unstable ununited fractures of the distal radius with severe radial deviation deformity present significant challenges.
  • These injuries can lead to functional impairment and resemble a radial club hand, impacting hand use.

Purpose of the Study:

  • To retrospectively review the outcomes of operative treatment for unstable ununited distal radius fractures with severe radial deviation.
  • To assess functional alignment and hand restoration in patients treated for this complex condition.

Main Methods:

  • Retrospective review of 15 adult patients with unstable ununited distal radius fractures and severe radial deviation.
  • Surgical interventions included wrist arthrodesis, plate fixation with autogenous bone grafting, brachioradialis/flexor carpi radialis z-lengthening, and distraction histogenesis (Ilizarov).

Related Experiment Videos

  • Distal ulna excision and use as bone graft were performed in eight patients.

    • Main Results:

    • All 15 patients achieved functional alignment and restoration of hand use at an average follow-up of 25 months.
    • Twelve patients were treated with plate fixation and bone grafting; three with wrist arthrodesis.
    • Concomitant injuries included ulnar fractures (6 patients) and distal radioulnar joint dislocations (4 patients).

    Conclusions:

    • Operative treatment, including plate fixation, bone grafting, and deformity correction techniques, is effective for unstable ununited distal radius fractures with severe radial deviation.
    • Restoration of functional alignment and hand use can be achieved even in complex cases with long-standing nonunion and associated injuries.
    • Surgical strategies should address both fracture healing and deformity correction for optimal patient outcomes.