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RADIAL CLUB HAND ULNAR CLUB HAND

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RADIAL CLUB HAND ULNAR CLUB HAND

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    1. RADIAL CLUB HAND & ULNAR CLUB HAND DR.FAAIZ ALI SHAH

    2. RADIAL CLUB HAND DR.FAAIZ ALI SHAH

    3. OBJECTIVES

    4. The trainee should be able to answer: Q .A new born child is brought to you with radial club hand deformity: A) Name various structural defects which may be found in this child? B) Give time table for treating this child? (Fcps-II Sep 2002) Q. A child of two months of age is brought to you with radial club hand: A) Classify the condition? B) How would you manage this patient? C) What is the stage at which surgery is most beneficial? D) Which surgical procedure is most favoured? ( Fcps-II Sep 2010) Q. Examine the hands of this child? ( Fcps-II Short case)

    5. CLSSIFICATION OF CONGENITAL ANOMALIES(Swanson et al 1993) 1.Failure of formation of parts a)Transverse arrest(digital absence) b)Longitudinal arrest(radial/ulnar) 2.Failure of separation/differentation of parts a)Soft tissue(syndactly) b)bony(R/U synostosis) 3.Duplication(polydactly) 4.Overgrowth(macrodactly) 5.Undergrowth 6.Congenital constriction band syndrome 7.Generalized abnormalities & syndromes

    6. DEFINITION Radial clubhand is a deficiency along the preaxial or radial side of the extremity

    7. INCIDENCE 1:100,000 live births. 5-10% with family history Bilateral in 50% cases Rt > Lt M = F Complete absence > partial absence.

    8. HISTORICAL BACKGROUND In 1733, Petit first described radial club hand in an autopsy of a neonate with bilateral club hands and absent radii.

    9. AETIOLOGY Most cases are sporadic without any definable cause. Exposure to teratogens, such as thalidomide and radiation.

    10. CLINICAL FEATURES Short forearm and radially deviated hand Thumb absent or severely deficient; Small hand ,limited MPJ flexion Stiff elbow in extension

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