Non-Surgical Treatment options for Radial Dysplasia (radial club hand, radial longitudinal deficiency) in Children

At Boston Children's Hospital, experts in our Orthopedic Center's Hand and Orthopedic Upper Extremity Program and our Plastic Surgery Department's Hand and Microsurgery Reconstructive Program provide comprehensive care — including evaluation, diagnosis, consultation, surgery, non-surgical therapies and follow-up care.

Goals of treatment

•   correct the radial deviation of the wrist
•   balance the wrist on the forearm
•   maintain wrist and finger mobility
•   maximize hand function
•   preserve forearm growth
•   improve appearance

Exercises and splinting

During infancy, the goal of treatment is to allow your child's wrist to extend and her elbow to move into a normal position. Your child's doctor will guide you in performing stretching exercises for your child's wrist and elbow at home to help accomplish this goal. More severe cases may require casting or splinting to gradually stretch the contracted soft tissues.

Once passive motion (motion guided by a helper) is achieved, your baby will likely need to wear a splint during the night throughout her infancy and during periods of rapid growth. Even if your child needs surgery, keep in mind that the range-of-motion exercises are extremely important.

Any improvement in range of motion achieved through exercise will make subsequent surgery more effective and perhaps less complex.

Should my child have surgery for radial dysplasia?

Treatment for radial dysplasia can be complex. Surgical treatment is usually needed to any correct deviation of the wrist that persists after stretching and splinting. But doctors also must weigh the decision to perform surgery against any other problems that your child may be experiencing due to other associated deformities or syndromes, including those of the:

•   heart (such as Holt-Oram syndrome, also called hand-heart syndrome)
•   kidneys, spinal column and/or digestive system (such as VACTERL syndrome)
•   blood cells (such as Fanconi anemia)

Also, if your child cannot flex her elbow, a bent wrist and short forearm can sometimes be an advantage, enabling your child to do things such as feed herself.

Learn more about the surgical treatment options for radial dysplasia.

Coping and support

At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for all you need to know about:

•   getting to Boston Children's
•   accommodations
•   navigating the hospital experience
•   resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with radial dysplasia. Will this affect my child long term? Will she be able to enjoy regular activities? Children's can connect you with extensive resources to help you and your family through this stressful time, including:

•   patient education: From doctor's appointments to physical therapy and recovery, our nurses and physical
    therapists will be on hand to walk you through your child's treatment and help answer any questions you may
    have—Why will my child need surgery? Are there non-surgical options? How long will her recovery take? How
    should we manage home exercises and physical therapy?
We'll help you coordinate and continue the care and
    support your child received while at Children's.
•   parent-to-parent: Want to talk with someone whose child has been treated for radial dysplasia? We can often
    put you in touch with other families who've been through the same process that you and your child are facing,
    and who will share their experiences.
•   faith-based support: If you're in need of spiritual support, we'll connect you with the Children's chaplaincy.
    Our program includes nearly a dozen clergy— representing Protestant, Jewish, Muslim, Roman Catholic and
    other faith traditions—who will listen to you, pray with you and help you observe your own faith practices
    during your hospital experience.
•   social work: Our social workers and mental health clinicians have helped many families in your situation.
    We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses
    relating to coping with illness and dealing with financial difficulties.