Radial Longitudinal Deficiency (Radial Club Hand)

What is radial longitudinal deficiency?

A diagnosis of radial longitudinal deficiency, previously known as radial club hand, and sometimes referred to as radial dysplasia, refers to a condition in which the radius bone of the forearm is underdeveloped or absent, resulting in a characteristic appearance of a hand and wrist that is angled toward the thumb-side of the forearm.

Radial longitudinal deficiency is a congenital (present at birth) condition in which the radius (the inner bone that connects the elbow to the forearm) did not form correctly in the womb. The radius may be malformed or missing.

Radial longitudinal deficiency affects between one in 55,000 and 100,000 babies.

What are the four types of radial longitudinal deficiency?

In most types of radial longitudinal deficiency, there can also be varying degrees of absent muscles, nerves and blood vessels — there’s a broad variability with each type and each case.

In diagnosing the condition, your doctor will likely classify it as one of the following four types:

Type 1

  • mildest form of radial longitudinal deficiency
  • mild deviation of the wrist underdevelopment of thumb may occur
  • problems that can result from more severe forms, such as loss of motion, usually don’t occur
  • typically, surgery required only to correct underdeveloped thumb (if present)

Type 2

  • limited growth of your child’s radius on both sides
  • wrist turned toward the radius, ulna bows out
  • underdevelopment of the thumb is usually more significant (if present)

Type 3

  • partial absence of the radius
  • wrist severely deviated, hand has limited support
  • ulna is thickened and bowed
  • associated problems with thumb and fingers, such as underdevelopment or camptodactyly, a deformity in the finger joints that causes a flexed finger or fingers (may be present)

Type 4

  • most common and most severe form 
  • complete absence of the radius (absent radius)
  • complete or near-complete absence of the thumb (thumb hypoplasia/aplasia
  • causes many limitations in the function of your child’s hand, wrist and forearm 
  • ulna bowing is the most severe 
  • index, long and ring fingers may be involved 
  • elbow may have limited range of motion

How we care for radial longitudinal deficiency

The Orthopedic Center’s Hand and Orthopedic Upper Extremity Program and our Plastic Surgery Department’s Hand and Microsurgery Reconstructive Program have treated thousands of babies and children with hand problems ranging from the routine to the highly complex. So we can provide your child with expert diagnosis, treatment and care — as well as the benefits of some of the most advanced clinical and scientific research in the world.

Our Orthopedic Center is nationally known as the preeminent center for the care of children and young adults with a wide range of developmental, congenital, neuromuscular, sports related, traumatic and post-traumatic problems of the musculoskeletal system.

Our Department of Pediatric Plastic Surgery provides comprehensive care and treatment for a wide variety of congenital and acquired conditions, including hand deformities. As one of the largest pediatric plastic surgery centers in the United States, we perform more than 3,000 surgeries and care for more than 14,000 children every year.