Evaluating Outcome of Surgical Centralization for Radial Club Hand in Children
Nguyen Ngoc Hung, MD1*, Hoang Hai Duc,MD, PhD2, Le Tuan Anh, MD2 and Phung Cong Sang, MD2
1 Professor, Hong Phat General Hospital, 219 Le Duan Street, Hai Ba Trung District, Hanoi city, Vietnam.
2 National Hospital for Pediatrics, Hanoi city, Vietnam.
*Corresponding Author: Nguyen Ngoc Hung, MD, Professor, Hong Phat General Hospital, 219 Le Duan Street, Hai Ba Trung District, Hanoi city, Vietnam.
DOI: https://doi.org/10.58624/SVOAOR.2023.03.053
Received: August 30, 2023 Published: September 15, 2023
Abstract
Background: Various types of osteotomy have been proposed to treat Radial club hand. We reviewed the results of Ulnar osteotomy, Centralization, and tendon transfer.
Methods: Between 2000 and 2011, we treated 32 cases of Radial club hand with two Variants Variation 1 (n= 23): ulnar osteotomy; Variation 2 (n=9): without osteotomy; There were 23 patients. Male 10 and Female: 13. Unilateral: 14. Bilateral: 9. Mean age at Operation: 33 months and Follow Up: 56 months. We compared Wrist-Forearm, Hand-Forearm angles before and after surgery, range of motion for all patients.
Results: Surgical Centralization on all patients, and Ulnar Osteotomy on 23 forearms. The Patients was Operated according to separated two Variants; there were 23 Variant 1, mean Ulnar bow: 38.68° ±3.583 (33.6° – 45.2°); and there were 9 Variant 2. mean Ulnar bow: 28.15° ± 3.176 (25.7°—28.4°)without ulnar osteotomy. There were 14 patients with unilateral: 8 (57.1%) in V1, and 6 (42.9%) in V2. There were 9 patients with bilateral (18 radial club hand): 15 (83.3%) in V1, and 3 (16.7%) in V2. Compared results on V1 and V 2 with P-values are not significant. Conclusion: Centralization and Ulnar osteotomy technique for operative treatment of the radial club hand is presented. The improved mechanical forces are further stabilized by transposition of the radial wrist extensor and flexor; this favors a better muscle balance.
Keywords: Radial longitudinal deficiency, Centralization, Osteotomy, Masurement angle, Radial Club Hand.
Citation: Hung NN, Duc HH, Anh LT, Sang PC. Evaluating Outcome of Surgical Centralization for Radial Club Hand in Children. SVOA Orthopaedics 2023, 3:5, 111-126.