Bone lengthening of the radius with temporary external fixation of the wrist for mild radial club hand

Takagi, Takehiko; Seki, Atsuhito; Mochida, Joji; Takayama, Seiji

doi:10.1016/j.bjps.2014.08.048

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…BM Peterson et al [16] reported lengthening index of 8.6 weeks per cm. T Takagi et al [19] reported a mean healing index of 176.8 day/cm. S Farr et al [17] reported a fracture of the ulna after removal of the Ilizarov device in one patient, which was treated by plate fixation.…”

Section: Discussionmentioning

confidence: 99%

Management of congenital radial club hand by gradual correction

Hosny¹,

Ahmed²

2016

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Журнал клинической и экспериментальной ортопедии им. Г.А. Илизарова № 4, 2016 г. © Hosny Gamal A., Ahmed Abdel-Salam A., 2016. УДК 616.717.5-007.5-053.1-089.227.84 DOI 10.18019/1028-4427-2016 Лечение врожденной лучевой косорукости дозированной коррекцией Введение. Тяжёлая врождённая лучевая косорукость нежелательна с эстетической точки зрения. В данной статье представлен наш опыт лечения рано и поздно диагностированных случаев дозированной дистракцией с применением аппарата Илизарова для наружной фиксации. Методы. Нами пролечено 34 случая врождённой лучевой косорукости у пациентов в возрасте от одного года до 15 лет. Среди пациентов было 20 девочек, диагностировано восемь двусторонних случаев. В трёх случаях проведено двустороннее лечение. Таким образом, нами пролечено 37 конечностей. В девяти случаях больные были оперированы ранее. Только центрация была выполнена в 12 случаях, с последующим удлинением -в восьми случаях. В остальных случаях проводили удлинение локтевой кости и дозированную коррекцию деформаций запястья. Контроль следующих параметров у пациентов проводили клинически и по рентгенограммам: угол между кистью и предплечьем, объём движений, повседневная функциональная активность, степень достигнутого удлинения и улучшение в косметическом плане. Результаты. Период контроля варьировал от одного года до 10 лет. Величина достигнутого удлинения составляла от пяти до 11 см. Средний индекс заживления составлял 52,02 дн./ см, во всех случаях отмечено удовлетворение косметическим видом. Имели место следующие осложнения: инфицирование путей проведения спиц в 24 случаях, сгибательные контрактуры локтя и пальцев кисти -в 26 случаях [которые большей частью не проявлялись при контроле] и спонтанное локте-запястное слияние в двух случаях. В двух случаях произошёл перелом в зоне регенерата. Выводы. Применение метода Илизарова с дозированной дистракцией кости и мягких тканей при лечении лучевой косорукости было эффективным при удлинении предплечья с улучшением в функциональном и косметическом плане. Ключевые слова: дистракционный остеогенез, Илизаров, лучевая косорукость, удлинение локтевой кости Introduction Severe congenital radial club hand is aesthetically unacceptable. This paper represents our experience in treating early and late diagnosed cases using gradual distraction by Ilizarov external fixator. Methods We treated 34 cases of congenital radial club hand with an age ranged from 1 to 15 years. There were 20 girls and eight bilateral cases. Three had been treated on both sides. So, we have treated 37 limbs. Nine cases had been operated before. Centralization alone was done in 12 cases and followed by lengthening in eight cases. Ulnar lengthening and gradual correction of wrist deformities were done for the rest of cases. The patients were followed clinically and radiographically with the following parameters: hand forearm angle, range of motion, daily functional activities, extent of lengthening achieved, and cosmetic improvement. Results The follow up ranged from 1 to 10 years. The magnitude of lengtheni...

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Section: Discussionmentioning

confidence: 99%

Management of congenital radial club hand by gradual correction

Hosny¹,

Ahmed²

2016

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“…Исследований, посвященных удлинению лучевой кости у детей с врожденной лучевой косорукостью II типа, в мировой литературе представлено незначительное количество. Однако все авторы сообщают о рецидиве девиации кисти при применении метода компрессионно-дистракционного остеосинтеза [6,14,19]. Уменьшение длины лучевой кости может быть вызвано снижением высоты регенерата после удлинения, а также резорбцией костной ткани в дистальном отделе лучевой кости.…”

Section: результаты исследованияunclassified

Lengthening of radius in patients with congenital radial club hand, type II

Avdeychik

Валерьевна²,

Golyana

et al. 2019

Pediatr Traum Orthop Reconstr Surg

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Background. Congenital radial club hand (CRCH) is characterized by longitudinal underdevelopment of the forearm and hand on the radial surface. Underdevelopment can range from hypoplasia to aplasia of the radius. More than 50 methods to correct the forearm deformities, depending on the degree of radius underdevelopment, have been proposed. Aim. We evaluated the results of CRCH treatment using microsurgical technique and external fixation. Methods. We analyzed 16 patients (age, 4.6 0.9 years) with CRCH type II, according to the classification of Bayne and Klug, treated between 1994 and 2017. The patients were divided into two groups: Group 1 were patients undergoing microsurgical autotransplants of the epimetaphyseal second metatarsal bone with growth plate to the position of the radius defect and group 2 were patients treated by lengthening of the radius with external fixation. We analyzed the types of deformities, size of the radius defects, and range of motion in upper limb joints before the stage of the lengthening. External fixation index and number of complications also were determined. The type and number of recurrent deformities and timing of their detection were analyzed. Results. The observation period ranged from 12 months to 10 years (average, 3.8 years). In group 1, good results were obtained in 62.5% of cases. After transplantation of the metatarsal bone growth plate, the work of the growth plate continued, characterized by increasing radius length in the later observation period. In group 2, good results were obtained in 50% of cases. Clinical and X-ray examinations showed recurrent hand deviation and radius shortening, which required repeated radius lengthening. Conclusion. Microsurgical transplantation of the second metatarsal bone with growth plate is accepted more in reconstruction of the radial bone in patients with CRCH type II due to creation of a growth zone in the distal part of the radius. Radius lengthening via external fixation is applicable while maintaining the distal epimetaphysis and normal transverse dimensions of the radial bone.

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“…Correction loss is avoided during growth in our method because the lengthened bone includes the growth plate. In addition, a good range of motion may be also be acquired due to temporary traction of the wrist using an external fixation device without producing growth plate damage [27]. …”

Section: Treatment - Surgerymentioning

confidence: 99%

“…In the present review, we explain our centralization procedure with tendon transfer for Bayne Type III or Type IV, and our bone lengthening of the radius with temporary external fixation of the wrist [27]. for Bayne Type I or Type II.…”

Section: Treatment - Surgerymentioning

confidence: 99%

Current Concepts in Radial Club Hand

Takagi

Seki

Takayama

et al. 2017

TOORTHJ

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Radial club hand is a complex congenital abnormality of the radial or pre-axial border of the upper extremity. It has a wide range of phenotypes from hypoplasia of the thumb to complete absence of the radius and the first ray. Centralization with tendon transfer is a popular method for maintaining the correct position of radial club hand. On the other hand, various corrections were devised, e.g. radialization after distraction to emphasize the fact that the head of the ulna is positioned under the radial carpal bones and is no longer placed in a slot in the center of the carpus, microvascular epiphysis transfer, gradual correction using Ilizarov method, for Bayne Type III or Type IV. We should pay attention to the recurrence of radial deformity or circulatory impairment with the tension. Lunate excision or ulnar shortening can be selected for tension-free correction. Radialization can be indicated for avoiding the recurrence of radial flexion. However, we should pay attention of the radial protrusion of the ulnar head. For avoiding the recurrence of radial deformity or circulatory impairment, gradual correction using Ilizarov external fixation can be indicated, especially in the cases with severe radial deviation or with short forearm. In the mild cases, Bayne Type I or Type II, radius lengthening is accompanied by a soft-tissue distraction or release at the ulnar carpal joint with keeping wrist and forearm motion without producing growth plate damage.

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Bone lengthening of the radius with temporary external fixation of the wrist for mild radial club hand

Cited by 7 publications

References 9 publications

Management of congenital radial club hand by gradual correction

Management of congenital radial club hand by gradual correction

Lengthening of radius in patients with congenital radial club hand, type II

Current Concepts in Radial Club Hand

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