There are two long bones comprising the forearm, the radius and the ulna. When the radius fails to develop normally (ie, radial hypoplasia or dysplasia), an inward rotation or collapse of the wrist can result towards the thumb side. This is referred to as a club hand, or radial club hand, deformity. The affected arm is shorter, with curving of the forearm and stiffness of the elbow and fingers. In many cases, some element of hypoplastic thumb is also present.
club hand deformity.
See “Hypoplastic Thumb” section for further details. The occurrence of radial dysplasia is usually sporadic, meaning that it occurs by chance and for no apparent reason. However, it may be associated with other defects or syndromes. The condition occurs 1 in 55,000-100,000 babies.
Hand function is severely affected in radial club hand deformity. Treatment is aimed at stabilizing the wrist, with the hand seated in a proper configuration. The muscles and tendons on the radius side of the forearm are also underdeveloped and shortened. Treatment must also RadialClubXRinclude stretching or lengthening of these elements to balance the hand on the wrist.
Depending upon the severity, surgically correcting a radial club hand deformity can be done in one or more stages. Serial casting before surgery can help stretch the tight muscles, ligaments, and tendons. This should be started in the first few months of life. Surgery is then performed to reposition the hand centrally on the wrist. This is called centralization. Alternatively, prior to centralization, stretching of tight structures can be achieved with initial application of an external distraction device. This device is placed surgically on the hand and forearm and is gradually adjusted at home on a daily basis to move the hand more centrally and stretch out tight anatomic structures. When the desired position is achieved, the centralization procedure is then performed.
It is not uncommon for children to require multiple surgeries over the course of their lifetime to help correct residual curvature, lengthen the forearm, or improve hand function.
with radial club hand deformity.
Why choose Dr Panossian
- He received his medical education at Tufts University School of Medicine.
- Graduated at the top of his class at UCLA, receiving Phi Beta Kappa and Summa Cum Laude honors.
- Was accepted into an elite combined general surgery and plastic surgery residency at the Keck School of Medicine of USC.
- Completed subspecialty training in craniofacial surgery at the Hospital for Sick Children in Toronto and Harvard Medical School.
- Was mentored by Dr. Ron Zuker in the practice of facial paralysis reconstruction. This prestigious fellowship position was available to only one surgeon in the United States.
- Is affiliated with various charitable and educational organizations, including Operation Smile and Mending Kids.
- Is a member of the American Society of Plastic Surgeons and the highly selective American Association of Plastic Surgeons, reserved for only a select group of individuals nationally who have demonstrated excellence in academic plastic surgery.
- Holds memberships in several other professional societies including the American College of Surgeons and the American Society of Reconstructive Microsurgery.
- He serves on the Board of Directors for Mending Kids and the Gondobay Manga Foundation, a non-profit organization dedicated to the improvement of lives in Sierra Leone.
- Has been nominated by his peers annually since 2012 as a “Super Doctor.”
- Served as an expert medical consultant and appeared on The Doctors, Grey’s Anatomy, and Nip/Tuck.
- Has been featured as “Top Doctor” in US News and World Report, Pasadena Magazine, and Los Angeles Magazine.
Last modified by Dr. Andre Panossian
