Posttraumatic radial club hand.
Fifteen adult patients with an unstable ununited fracture of the distal third of the radius and severe radial deviation deformity resembling a radial club hand were retrospectively reviewed at an average of 25 months after operative treatment. There were eight women and seven men with an average age of 57 years (range, 33-79 years). The average duration of nonunion was 56 months (range, 6-252 months). Six patients had a concomitant fracture of the ulna and four had dislocation of the distal radioulnar joint. Three patients were treated with wrist arthrodesis and 12 with plate fixation and autogenous bone grafting. The distal ulna was excised and used for bone graft in eight patients. Correction of deformity was facilitated by z-lengthening of the brachioradialis and flexor carpal radialis in four patients and distraction histogenesis (llizarov) in two patients. One patient failed to heal the fracture and was treated with wrist arthrodesis. Functional alignment and use of the hand was restored in all patients.
Ring
David
D
Harvard Medical School, Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA. dring@partners.org
Prommersberger
Karl
K
Jupiter
Jesse B
JB
D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D017759:Fractures, Malunited / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D011885:Radius Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery