Bone lengthening of the radius with temporary external fixation of the wrist for mild radial club hand.

BACKGROUND: We report the utility of a surgical approach to treat mild (Bayne type I or II) radial club hand with a combination of radial bone lengthening and temporary external fixation between the ulna and the metacarpals.

METHODS: We evaluated five radial club hands that received a new procedure involving radius lengthening with external fixation to support the radial side of the wrist. The evaluation included an assessment of radial deficiency deformity recurrence from the anteroposterior radiographs and a measurement of the passive range of wrist motion with the use of a goniometer before surgery and at the time of the final follow-up. We recorded complications such as infection and nerve palsy.

RESULTS: The healing index of the radius was from 72.2 to 298.9 day/cm (mean, 176.8 day/cm). The mean radial/ulnar deviation was 84.0/-14.0° before surgery and 37.0/13.0° at the time of the final follow-up. No correction loss was detected during the follow-up. All patients were able to hold and bring an object to the mouth after surgery. No patient had a postoperative infection and there were no cases of nerve palsy.

CONCLUSIONS: All cases demonstrated a better range of motion despite a poor healing index in the present series. Our novel technique can be performed for cases with mild radial deficiency and with mild radius deficiency including growth plate injuries.