Ulnar longitudinal deficiency: a rare case report and review

Akshay Lamba, Naresh Kumar, Chaitanya Krishna, Sargam Chhabra


Ulnar hemimelia is a rare postaxial partial or complete longitudinal deficiency of ulna. It has an estimated incidence of 1/100,000-150,000 live births, with a male to female ratio of 3:2. There is usually ulnar deviation of hand and shortening of forearm. Radial head subluxation and fixed flexion deformity of the hand may be associated with it. Complex carpal, metacarpal, and digital abnormalities including absence of triquetrum, capitate and three fingered hand (tridactyly) are additional findings commonly found in association. Here, we present a case of a 17-year-old female with left sided ulnar club hand due to isolated partial ulnar aplasia.


Aplasia, Ectromelia, Hemimelia, Ulna, Upper extremity deformities, Congenital

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Frantz CH, O'Rahilly R. Ulnar Hemimelia. Artificial Limbs. 1971;15:25-35.

Drachman DB, Sokoloff. The role of movement in embryonic joint development. Develop Biol. 1966;14:401-20.

Duken J. Uber der Beziehungen zwischen Assimilationshypophalangie und Aplasie der Interphalangealgelenke. Virchows Arch Path Anat Physiol. 1921;233:204-25.

Al-Qattan MM, Al-Thunyan A. Ulnar Deficiencies. In: Abzug J, Kozin S, Zlotolow D. (eds). The Pediatric Upper Extremity. Springer, New York, NY. 2015.

Agrawal AK, Kosada D, Patel S, Patel J, Desai S, Patwa JJ. Ulnar hemimelia in deformed left forearm treated with Ilizarov fixator. Int J Orthop Sci. 2017;3:1013-6.

Panda A, Gamanagatti S, Jana M, Gupta AK. Skeletal dysplasias: a radiographic approach and review of common non-lethal skeletal dysplasias. World J Radiol. 2014;6:808-25.

Palmucci S, Attinà G, Lanza ML. Imaging findings of mucopolysaccharidoses: a pictorial review. Insights Imaging. 2013;4:443-59.

Aucourt J, Budzik JF, Manouvrier S, Mezel A, Cagneaux M, Boutry N, et al. Congenital upper limb malformations: pictorial review. ECR 2011/C-2085.

Al-Qattan MM, Al-Sahabi A, Al-Arfaj N. Ulnar ray deficiency: a review of the classification systems, the clinical features in 72 cases, and related developmental biology. J Hand Surg Eur. 2010;35:699-707.

Bayne LG. Ulnar club hand (ulnar deficiencies). In: Green DP (Ed.) Operative hand surgery. New York: Churchill Livingstone. 1982;245-57.

Goldfarb CA, Manske PR, Busa R, Mill J, Carter P, Ezaki M. Upper-extremity phocomelia reexamined: a longitudinal dysplasia. J Bone Joint Surg Am. 2005;87:2639-48.

Havenhill TG, Manske PR, Patel A, Goldfarb CA. Type ‘0’ ulnar longitudinal deficiency. J Hand Surg Am. 2005;30:1288-93.

Özdemir M, Turan A, Kavak RP. Ulnar hemimelia: a report of four cases. Skeletal Radiol. 2019;48:1137-43.