Surgical treatment of proximal forms of congenital ectromelia of the upper limbs in children

Three cases of the proximal form of congenital upper extremities ectromelia (two cases in 4 years and 1 case in 9 years old patient) are presented. The combination of symptoms of this rare malformation including the defects of the arm and forearm bones as well as aplasia of the radial rays of the wrist is described. Complex program for surgical treatment of ectromelia is suggested. The program includes the reconstruction of the arm length and formation of the shoulder using microsurgical transplantation of the fragment of the external border of the scapula, elimination of the forearm deformity by double-sided centering of the wrist, restoration of holding function using either the separation of one of triphalangeal fingers or transplantation of toes to the position of I radial ray. The results achieved in those three patients allowed to represent the new program as an alternative to the prosthetics.