Pre-centralization soft tissue distraction for Bayne type IV congenital radial deficiency in children.

There are several surgical options for the treatment of severe congenital radial deficiency. The aim of the current study was to evaluate the results of a staged protocol consisting of gradual soft tissue distraction with an Ilizarov external fixator followed by centralization of the ulna. Three patients (four extremities) with Bayne type IV radial club hand were treated at an average age of 18 months. At a follow-up of 26 months, an average correction of 72 degrees in the hand-forearm angle and an improvement of 19 mm in the hand-forearm position were obtained. There were no cases of neurovascular compromise, wound infection, carpal resection, or ulnar shortening. All families were pleased with the results. These findings suggest that a staged surgical approach is a technically feasible alternative in the treatment of severe congenital radial club hand deformity in young children.