Clinical and functional results of radial club hand with centralization and pollicization using the second metacarpus: A clinical case series.

INTRODUCTION

Radial club hand (RCH) is a rare congenital deformity leading in several functional and psychological problems. However, our knowledge about the long-term functional outcomes of treating RCH is limited. In current study, we investigated the outcomes of centralization and pollicization using second or third metacarpal bone in RCH patients.

METHODS

There were 15 hands (13 patients) with RCH underwent centralization and pollicization using second or third metacarpal bone or tendon transfer. The patients aged 1.2 ± 1 years at the time of the surgery. On early postoperative x-rays, the forearm-hand angle was measured. The patients were followed for 6.2 ± 2.3 years. At the final visit, disabilities of arm, shoulder and hand (DASH) score was completed. Furthermore, forearm-hand angle and range of motion of both wrists in sagittal and coronal planes were measured.

RESULTS

The mean of forearm-hand angle increased significantly. In 11 wrists, forearm-hand angle increased only 10 degrees of less. The range of operated wrist was improved in sagittal and coronal planes. The relative range of wrist motion in patients with unilateral deformity in sagittal and coronal planes was 83 ± 11 percent and 61 ± 12 percent. Three patients developed skin necrosis.

CONCLUSION

Early centralization and pollicization using second or third metacarpal bone can significantly restore the range of motion and function in patients with RCH.