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Acquired ulnar clubhand resulting from neonatal osteomyelitis

L De Smet1, P Gunst, G Fabry

  • 1Department of Orthopaedic Surgery, University Hospital Pellenberg, K.U. Leuven, Belgium.

Journal of Pediatric Orthopedics. Part B
|March 3, 1998
PubMed
Summary

Ulnar clubhand, a rare congenital deformity, can result from postnatal osteomyelitis. In this case, despite significant wrist deviation, good hand function meant surgery was not pursued.

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Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Congenital Hand Deformities

Background:

  • Ulnar clubhand is a rare congenital limb deficiency characterized by underdevelopment of the ulna.
  • Postnatal osteomyelitis of the ulna is an uncommon cause of acquired ulnar deficiency.
  • This case presents a unique etiology for ulnar deviation of the wrist.

Observation:

  • A patient presented with clinical features of ulnar clubhand following a diagnosis of postnatal osteomyelitis of the ulna.
  • Radiographic examination revealed significant ulnar deviation of the wrist and a marked ulnar slope of the distal radius.
  • Despite the radiographic findings, the patient demonstrated good functional use of the affected hand.

Findings:

  • The combination of postnatal ulnar osteomyelitis and subsequent ulnar clubhand deformity is infrequently reported.

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  • The degree of radial slope and wrist deviation did not correlate with the patient's functional hand capacity.
  • Preservation of good hand function in the presence of significant bony deformity was a key observation.

    • Implications:

    • This case highlights that surgical intervention for ulnar clubhand may not be necessary when functional outcomes are satisfactory.
    • It suggests that functional assessment should be a primary consideration in managing congenital or acquired upper limb deformities.
    • Further research into the long-term functional outcomes of non-surgically managed ulnar clubhand is warranted.