Radius Lengthening for the Treatment of Bayne and Klug Type II and Type III Radial Longitudinal Deficiency

Our Experiences in the Surgical Treatment of Bayne Type III and IV Radial Longitudinal Deficiencies

“…Matsuno and colleagues described an improvement in wrist radial deviation using radial extension in Bayne and Klug type 2-3 cases. Radius extension provides wrist and radial movements in type 2-3 patients; because of continuous growth in children, other extensions may be required to avoid recurrences (18). Suneel B. Bhat and colleagues used the multi-axial correction (MAC) method for ulnar extension in Bayne type 4 cases.…”

Radial Deficiency

“…Treatment of type II RLD has included distraction lengthening of the hypoplastic radius (Manske and McCarroll 1998;Matsuno et al 2006). Matsuno, in a small series of four patients, described a technique using external distractors placed on both the ulna and the radius in an attempt to correct both radial height and wrist position.…”

“…Unfortunately, results were poor and require extended treatment, with absorption of regenerate bone occurring after distraction attempts. If one chooses to utilize this technique, patients and parents should be aware that delayed consolidation or malunion of the radius can occur and that three or more lengthening procedures may be required to gain and maintain appropriate length (Matsuno et al 2006). …”

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

“…Matsuno et al developed a new approach with a combination of radius bone lengthening and soft-tissue traction between the ulna and third metacarpal. 2 This device distracted the ulnar side of the wrist, although it is important to distract soft tissue at the radial side of the wrist for radial deficiency. In fact, severe radial deviation of the wrist recurred with this procedure.…”

“…In fact, severe radial deviation of the wrist recurred with this procedure. 2 To solve the recurrence, we first applied soft-tissue release at the radial side of the wrist for mild (Bayne type I, short distal radius, or II, hypoplastic radius 3 ) radial deficiency, because the radius in severe cases of radial deficiency (Bayne III, partial absence of the radius, or IV, total absence) cannot be attached to the external fixator to extend the bone. After that, we applied an approach of treating with a combination of radius bone lengthening and temporary external fixation between the ulna and the metacarpals to support the radial side of the wrist and avoid the loss of correction.…”