In radial dysplasia:
The ulna is usually affected. It is frequently short and radially bowed.
Poor results in the treatment of radial club hand are due to:
All of the above. The treatment of radial dysplasia (previously called club hand) includes a team effort in which the parents or guardian play an important role in the success of the treatment, by stretching the soft tissue with passive exercises and postoperatively making sure the patient wears an adequate brace to maintain the correction until the skeleton is fully mature. Selecting patients for surgical intervention is the first step in achieving good and excellent results.
References: 1. Bayne LG, Klug MS. Long-term review of the surgical treatment of radial deficiencies. J Hand Surg [Am] 1987; 12(2): 169-79.
Fanconi pancytopenia includes:
All of the above. Fanconi anaemia was described for the first time in 1927. It is an autosomal recessive disease that presents as a progressive pancytopenia, usually late in the first decade of life, in association with multiple anomalies (Table below).
Fanconi anaemia and associated multiple anomalies:
References: 1. Tarantino MD, Kline RM. Hematologic disorders and the hand. In: The growing hand: diagnosis and management of the upper extremity in children. Gupta A, Kay SPJ, Scheker LR. St. Louis, USA: Mosby, 2000: 401-14.
In radial dysplasia - utilizing the Ilizarov system, limb lengthening is associated with:
All of the above. Children affected with radial dysplasia have a tendency to have stiff fingers with marked hypoplasia from radial to ulnar, the index finger is less developed than the small finger and on occasion the small finger is bigger than the index and middle fingers. The muscles are short and the median nerve runs on the radial aspect of the forearm under considerable tension. Lengthening of the forearm makes the median nerve even tighter and the fingers stiffer.
In a study on radial dysplasia and limb lengthening, six children with radial dysplasia had distraction lengthening of the ulna. The mean lengthening achieved was 4.7cm (46% of original ulna length). Complications included nocturnal pain, pin tract infection and callus fracture or delayed union. Distraction lengthening of the ulna facilitated activities of daily living, such as reaching the perineum or driving, but at the cost of an increased complication rate. The high rate of callus fractures highlighted the need for regular radiographic review during distraction and suggests that after distraction it may take more than 4 weeks for satisfactory callus consolidation before removal of the fixator.
References: 1. Pickford MA, Scheker LR. Distraction lengthening of the ulna in radial club hand using the Ilizarov technique. J Hand Surg [Br] 1998; 23(2): 186-91.
Rupture of the C5 and C6 roots will paralyze which group of muscles?
References:
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