The Association of Radial Deficiency with Thumb Hypoplasia

James, Michelle A.; Green, Hillary D.; McCarroll, H. Relton; Manske, Paul R.

doi:10.2106/00004623-200410000-00010

Cited by 64 publications

(45 citation statements)

References 35 publications

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“…Several studies have supported the growing body of evidence that the components of radial longitudinal deficiency represent a progressive spectrum of upper extremity abnormalities with a distal progression of severity. [4][5][6] Carpal anomalies link thumb hypoplasia with radial deficiency in a way that isolated thumb hypoplasia represents radial deficiency in its mildest form, the addition of carpal anomalies represent the intermediate form, while the absence or abnormality of all radial structures is the severe form of the congenital difference. 7 Furthermore, it has been observed that the long-term sequelae of patients with untreated hypoplastic thumbs leads to progressive carpal collapse in adulthood.…”

Section: Discussionmentioning

confidence: 99%

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement

Papadogeorgou

Soucacos

2008

Microsurgery

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Congenital thumb hypoplasia is a complex and heterogeneous congenital difference that is detrimental to hand function. Apart from its' classic form, which is now considered to be part of radial dysplasia, it can occur as part of other congenital anomalies including, syndactyly, symbrachydactyly, atypical cleft hand, bifid thumb, triphalangeal thumb, mirror hand, constriction band syndrome, as well as generalized anomalies and syndromes. Management is aimed primarily at restoring basic hand function, specifically, power grasp and precision pinch, and secondarily to improve cosmoses, which inevitably is going to be impaired. Several treatment alternatives have been proposed to manage the specific disabling condition and include, 1st web space reconstruction and opponensplasty, pollicization, toe-to-hand transfer, distraction lengthening, free toe phalangeal transfer or the use of allograft, stabilization of the metacarpophalangeal joint, and surgery of "spare parts." The purpose of this study is to evaluate the various alternatives available today and propose an algorithm applicable for the appropriate management of thumb deficiency, based on their specific characteristics.

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Section: Discussionmentioning

confidence: 99%

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement

Papadogeorgou

Soucacos

2008

Microsurgery

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“…8,9 It is well known that patients with radial longitudinal deficiency may have abnormalities of the thumb. Recent work by James et al 6 found that as the severity of radial deficiency increased, the degree of thumb hypoplasia tended to be more severe.…”

Section: Epidemiology and Associated Conditionsmentioning

confidence: 98%

Thumb Hypoplasia

Riley

Burgess

2009

The Journal of Hand Surgery

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Hypoplasia of the thumb refers to a spectrum of clinical abnormalities ranging from a slightly small digit to complete absence (or aplasia) of the thumb unit. As a component of radial dysplasia, thumb hypoplasia can be either an isolated entity or seen in conjunction with other elements of radial longitudinal deficiency. Treatment of this condition initially involves identifying and addressing co-morbid anomalies in other body systems. The severity of thumb hypoplasia is then graded so that appropriate treatment methods can be instituted. The goal of treatment is ultimately to provide the child with a stable and functional thumb unit.

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“…The most common syndromes associated with RLD include the VACTERL association, HoltOram syndrome, Fanconi's anemia, and thrombocytopenia-absent radius (TAR) syndrome (Riordan 1955;Heikel 1959;Fanconi 1967;Skerik and Flatt 1969;Lamb 1977Lamb , 1991Manske et al 1981;Wynne-Davies and Lamb 1985;Bayne and Klug 1987;Urban and Osterman 1990;Botto et al 1997;James et al 1999James et al , 2004Maschke et al 2007). These syndromes will be discussed in more detail, while a list of other associated anomalies is provided in Tables 1 and 2.…”

Section: Associated Anomalies and Syndromesmentioning

confidence: 99%

“…Type 0 RLD, which represents the radial-deviated hand with a normal-length radius, is caused by a deficiency in the radial wrist extensors and flexors (Mo and Manske 2004;James et al 2004). Not all patients with type 0, type I, or type II RLD need surgical correction.…”

Section: Surgical Treatment Of Rld Types 0-i-iimentioning

confidence: 99%

Radial Deficiency

Alphen

Moran

2014

The Pediatric Upper Extremity

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Radial longitudinal deficiency (RLD) is a congenital disorder characterized by hypoplasia of both the radius and soft tissue structures on the preaxial side of the forearm. Clinical presentation can vary within a spectrum of severity ranging from mild cosmetic deformity to complete absence of the radius and thumb. Despite over 250 years of investigation, current surgical treatment of this disorder is still inadequate in restoring "normal" function and appearance within the wrist. Shortcomings in surgical management have made a standardized treatment algorithm for RLD controversial; however centralization and radialization remain the mainstay of surgical treatment. This chapter will attempt to provide an overview of the deformity and present a review of treatment options.

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The Association of Radial Deficiency with Thumb Hypoplasia

Abstract: "The association of radial deficiency with thumb hypoplasia

Cited by 64 publications

References 35 publications

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement

Treatment alternatives of congenital hand differences with thumb hypoplasia involvement

Thumb Hypoplasia

Radial Deficiency

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