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Journal of Children's Orthopaedics
Published in: Journal of Children's Orthopaedics 6/2009

Open Access 01-12-2009 | Technical Note

Multi-axial correction system in the treatment of radial club hand

Authors: Suneel B. Bhat, Atul F. Kamath, Kriti Sehgal, B. David Horn, Harish S. Hosalkar

Published in: Journal of Children's Orthopaedics | Issue 6/2009

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Abstract

Background

Radial club hand is a well-recognized congenital malformation characterized by hypoplasia of bone and soft tissue on the radial aspect of the forearm and hand. The modalities of treatment have traditionally varied from stretching casts with soft-tissue procedures to the use of multiple corrective osteotomies. These osteotomies can be stabilized by a variety of methods, including external fixators that allow the possibility of gradual distraction with neohistiogenesis. This current study outlines the usage of one such device (multi-axial correction system [MAC]) in the management of deformity associated with severe radial club hand.

Methods

Three consecutive cases of unilateral or bilateral severe (Bayne type IV) congenital radial club hand were corrected using MAC fixation in the last 5 years. This is a retrospective review of all three cases. Data parameters included: patient demographics, presentation findings, degree of deformity, amount of correction/lengthening, length of procedure, length of treatment, and associated complications. The surgical technique is described in detail for the benefit of the readership.

Results

The three patients with severe congenital radial club hand had a total of four limb involvements that underwent correction using osteotomies and usage of the MAC device for external fixation. All three patients underwent successful correction of deformity with the restoration of alignment, lengthening of forearm for improvement of function, and stabilization of the wrist (mean duration, mean lengthening, mean time to consolidation). The MAC system was well tolerated in all patients and associated complications were limited.

Conclusion

The MAC fixator seems to be a good alternative modality of stabilization and correction for severe congenital radial club hand deformities. Its usage is fairly simple and it provides the ease of application of a mono-lateral fixator with far superior three-dimensional control, like the circular external fixator. We recommend that clinicians should add this modality to their armamentarium for the deformity correction of severe radial club hand and others in general.
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Metadata
Title
Multi-axial correction system in the treatment of radial club hand
Authors
Suneel B. Bhat
Atul F. Kamath
Kriti Sehgal
B. David Horn
Harish S. Hosalkar
Publication date
01-12-2009
Publisher
Springer Berlin Heidelberg
Published in
Journal of Children's Orthopaedics / Issue 6/2009
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-009-0196-3

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