Congenital absence of the radius: the occupational therapist and a new orthosis

Congenital absence of the radius (radial club hand) is a relatively common and disabling limb deficiency characterized by dislocation of the hand and carpus from the single forearm bore, the ulna. An understanding of the clinical-pathologic anatomy and consequent disruption of hand mechanics enables the orthopedic surgeon and the occupational therapist to formulate a team approach to this birth defect that can result in maximum functional capability for the child. The role of the occupational therapist and a specific therapy program for early stimulation and achievement of hand function are described. Orthotic support of the arm is indispensable to successful management. The design and fabrication of a dynamic upper-extremity orthosis for radial club hand is presented.