"Less is More"- A Minimalistic Surgical Intervention to Correct the Right Upper Limb Deformity in an Isolated Right...

Radial club hand is a rare congenital condition (1 in 100,000) involving varying deformities on the radial side of the forearm, ranging from thumb underdevelopment to absence of the radius and related structures. It can be isolated or part of syndromes, such as thrombocytopenia-absent radius, Holt-Oram, or vertebral, anal, cardiac, tracheo-esophageal, renal, limb, and is bilateral in 50-72% of cases.

A 12-year-old right-handed girl presented with an isolated, non-syndromic right radial club hand and flexion deformity at the wrist and elbow, without functional impairment. Her pathology did not fit existing Bayne and Klug or Heikel classifications, as her proximal radius was absent but the distal epiphysis and wrist were developed. A corrective wedge osteotomy with bilobed skin flaps was performed to realign the forearm. No intervention was made at the wrist or musculotendinous units, resulting in an acceptable outcome.

Reasonable outcome could be obtained in a rare case of complex congenital anomaly like radial club hand following a minimalist approach of wedge osteotomy alone to correct the forearm deformity.