101ms
Updated: 5/21/2021

Ulnar Club Hand

0%
Topic
Review Topic
0
0
0%
0%
Evidence
1
0
0
Topic
Images
https://devupload.orthobullets.com/topic/6068/images/screenshot70.jpg
https://devupload.orthobullets.com/topic/6068/images/screenshot62.jpg
https://devupload.orthobullets.com/topic/6068/images/screenshot61.jpg
https://devupload.orthobullets.com/topic/6068/images/screenshot64.jpg
  • summary
    • Ulnar Club Hand is a congenital upper extremity deformity characterized by a deficiency of the ulna and/or ulnar-sided carpal structures.
    • Diagnosis is made clinically.
    • Treatment can be nonoperative or operative depending on hand position, thumb function, elbow stability and presence of syndactyly.
  • Epidemiology
    • Incidence
      • 5-10 times less common than radial club hand
  • Etiology
    • Associated conditions
      • medical
        • not associated with systemic conditions like radial club hand
      • orthopaedic conditions
        • PFFD
        • fibula deficiency
        • scoliosis
        • phocomelia
        • multiple hand abnormalities
          • almost all patients have absent ulnar sided digits
  • Presentation
    • Symptoms
      • limited function
      • usually painless
    • Physical exam
      • shortened, bowed forearm
      • decrease in elbow function
      • loss of ulnar digits
  • Classification
      • Bayne Classification
      • Type 0
      • Deficiencies of the carpus and/or hand only
      • Type I
      • Undersized ulna with both growth centers present
      • Type II
      • Part of the ulna is missing (typically the distal ulna is absent)
      • Type III
      • Absent ulna
      • Type IV
      • Radiohumeral synostosis
      • There is a subtype of each classification that is based on the first webspace
      • A = Normal
      • B = Mild deficiency of the webspace
      • C = Moderate to severe deficiency of the webspace
      • D = Absent webspace
  • Treatment
    • Goals
      • treatment depends on multiple factors including
        • hand position, thumb function, elbow stability, syndactyly
        • thumb condition is most important factor to consider for treatment
    • Nonoperative
      • stretching and splinting
        • indications
          • used in early stages of treatment
    • Operative
      • syndactyly release and digital rotation osteotomies
        • indications
          • done at 12-18 months of age
      • radial head resection and creation of a one-bone forearm
        • indications
          • Stage II to provide stability at the expense of forearm motion
            • there is no good option for restoring elbow motion
          • corrective procedures should not be performed until the child is at least 6 months old
      • osteotomy of the synostosis
        • indications
          • may be required in Stage IV to obtain elbow motion
Flashcards (0)
Cards
1 of 0
Evidence (1)
EXPERT COMMENTS (2)
Private Note