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Radial Club Hand in Children

  • Overview

    Combining training in adult and pediatric orthopedics, hand surgery, plastic surgery and microsurgery allows our surgeons to provide a comprehensive level of care unmatched in most other hospital settings.

    Donald S. Bae, MD, associate in Orthopedic Surgery, Boston Children's Hospital; Brian I. Labow, MD, principal investigator, Plastic Surgery, Boston Children's Hospital

    If your baby was born with radial dysplasia (radial club hand), we know that you and your family are concerned. So, please know that at Children’s Hospital Boston, we will approach your child’s treatment and care with sensitivity and support—for your child and your whole family.

    A diagnosis of 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 dysplasia 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.
    • In radial dysplasia:
      • The affected arm is shorter, with curving of the forearm and stiffness of the elbow and fingers.
      • thumb is either very small or missing.
    • The occurrence of radial dysplasia is usually sporadic (meaning that it occurs by chance, for no apparent reason), but it may be associated with any of several other defects or syndromes.
    • The condition occurs in between one in 55,000 and one in 100,000 babies.
    •  More than half of babies with radial dysplasia have the deformity in both limbs.
    • There are four types of radial dysplasia, corresponding to increasing degrees of severity and complexity. (See Tests for a classification of these types.)
    • Treatment usually begins in infancy with splinting, stretching and physical therapy.
    • Many affected children, except those with very mild cases may benefit from one or more surgeries, usually starting in the first year of life—but early splinting and stretching can help increase the effectiveness of later treatments.
    • Radial dysplasia can occur by itself (in isolation), or can be associated with genetic syndromes.
    • Radial dysplasia can recur following surgery in infancy, requiring additional surgery(ies).

    How Children’s Hospital Boston approaches radial dysplasia

    You can have peace of mind knowing that the skilled experts in our 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.

    Radial dysplasia: Reviewed by Donald Bae, MD and Brian Labow, MD

    © Children’s Hospital Boston, 2011

    We offer orthopedic care in lots of places
    Boston Children’s physicians provide orthopedic care at Children’s satellite locations in Lexington, Peabody, Weymouth and Waltham, as well as at our main campus in Boston.
    Plastic surgery research and innovation

    Researchers in our Plastic Surgery lab are constantly developing improved treatments for children suffering from the conditions that require plastic surgery. Our aim is to translate the knowledge gained in the laboratory back to the clinic to improve care for your child.

    If you live far from the United States, we can help

    As an international pediatric orthopedics center, Children’s treats young patients from all over the world. Our International Center assists families residing outside the United States: We facilitate the medical review of patient records; coordinate appointment scheduling; and help families with customs and immigration, transportation, hotel and housing accommodations.

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