07/23/2024
Radial longitudinal arrest (also called radial dysplasia and formerly called radial club hand) is the name we give to this condition: where one of the two bones in the arm (the radius) is shorter than normal, or missing. This condition doesn’t always have to be treated, but for patients or parents who want an operation, I move the hand to the end of the arm. This can be helpful so that the fingers are better positioned to reach things. This is type of operation is called centralization. I also rebalance some tendons to help hold the hand in its new position. There are many different ways to do this operation, and unfortunately none of them seem to keep the hand perfectly straight. For this young boy I used a newer technique that may be better at keeping the hand at the end of the arm. It is called a distal ulnar bifurcation arthroplasty. You can swipe to see some X-rays! For this in the know, this is a Bayne 4 radial longitudinal deficiency, treated as described by Ya-chao and others in a recent article. I also used a bilobe flap for soft tissue rearrangement. You can swipe further to see the fibrous anlage, persistent median artery, and radial displaced median nerve that are among the variants seen in this condition. This patient required an external fixator and will undergo pollicization at a later time.