Method of radioulnar superposition in the treatment of patients with congenital radial club hand

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Abstract

New technique for the treatment of congenital club foot in patients with great malformation of the radius in the distal forearm is presented. Surgical intervention consists of 2 stages. First the distraction device is applied to correct the radius deviation and simultaneously to descent the hand distally together with hypoplastic radius. On the second stage the distraction device is taken off, partial resection of the distal ulnar epiphysis and resection of the proximal end of the hypoplastic radius is performed with following reposition of the ends. This method radioulnar superposition enables to eliminate the club hand, to preserve the wrist joint and to restore its physiologic functions.

About the authors

V. S. Prokopovich

Children's Orthopedic Institute. G.I. Turner

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, St. Petersburg

References

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2. Fig. 1. Scheme of radioulnar superposition surgery for congenital radial clubhand. a — application of a distraction apparatus designed by the Institute named after A.I. G.I. Turner; (b) the proximal part of the hypoplastic radius and part of the distal epiphysis of the ulna to be resected (shaded); c — completion of the operation by fixing the brush with two knitting needles.

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3. Fig. 2. Radiographs of the left upper limb of patient S., 15 years old, with congenital radial club hand. a — before surgery: hypoplastic radius in the distal forearm; b — in the process of distraction; c — after radioulnar superposition surgery with fixation of the hand with Kirschner wires; d is the end result.

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4. Fig. 3. Appearance of the left upper limb of the same patient before the operation (a) and after the operation of radioulnar superposition (b).

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