الفهرس 
ContentsOnly 14 pages are availabe for public view
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Abstract
Congenital Radial Club Hand, despite very rare condition, it is one of the most common congenital disorders affecting the hand and upper limb. It is an intercalary congenital deformity involving the forearm, wrist and hand that characterized by hypoplasia of both the radius and soft tissue structures as muscles, tendons, vessels and nerves on the lateral side of the forearm typically presented with significant shortening of the forearm, radial inclination of the wrist, limited range of motion of fingers and impaired strength in grip and pinch. After approval from local Institutional Review Board (IRB) and obtaining written consents from parents of all cases, in the period from January 2010 to March 2017 a retrospective and prospective case series study was done including 12 radial club hands in 9 cases presented to the Hand and Upper limb Surgery unit; managed by centralization of the hand over the distal ulna. Our results of 12 centralizations in 9 patients with an average follow-up of 34 months showed significant improvement from a preoperative radial angulation of 62 degrees to 7 degrees immediately postoperative, losing 9 degrees of correction to be 16 degrees at middle follow-up, losing another 9 degrees of correction to be 25 degrees at the latest follow-up examination. There were no major complications. Complications included one immediate postoperative slowed capillary refill, which resolved after removing the wire in the immediate post-operative period; and one stitch abscess requiring removal of absorbable stitch slight debridement in the clinic. One patient required revision for recurrent deformity during his very long follow-up period. Centralization becomes the gold standard and remains the most commonly performed treatment modality to date for radial club hand deformities. More satisfactory results can be observed by good preoperative preparation, intraoperative meticulous care when dealing with distal ulnar epiphysis, scheduled postoperative physiotherapy, familial education and early surgery, especially if treatment is initiated as soon as the patients are diagnosed.