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Journal of Hand Surgery (European Volume)
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Articles

Preliminary Soft Tissue Distraction Using External Fixator in Radial Club Hand

R. K. KANOJIA
N. SHARMA
S. K. KAPOOR

From the Department of Orthopaedics, Lady Hardinge Medical College, Shahid Bhagat Singh Marg, New Delhi, India

Correspondence: Dr Neeraj Sharma, House No. 22a, Road No. 8, East Punjabi Bagh, New Delhi 110026, India. Tel.: +91 011 42460568, +91 9818146636; fax: +91 011 42460568.E-mail: neerajorth{at}yahoo.co.in.

Preliminary soft tissue distraction using an external fixator before centralisation and tendon transfer of the flexor and extensor carpi ulnaris to the little finger metacarpal was used to treat Bayne’s type III and IV deformities in 18 hands of 14 patients with radial club hands. Treatment with external fixator was started at a mean age of 8 (range 3–30) months. In 16 of 18 hands, the surgical treatment was completed before 10 months of age. Adequate soft tissue stretching was achieved before centralisation using fractional distraction with the external fixator in the majority of hands. After an average follow-up period of 31 months, there were seven good, eight satisfactory and one unsatisfactory result.

Key Words: staged-fractional distraction • external fixator • centralisation • radial club hand • early childhood

Journal of Hand Surgery (European Volume), Vol. 33, No. 5, 622-627 (2008)
DOI: 10.1177/1753193408093809
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