Radial club hand managed with ulnar osteotomy and centralization of hand: a case report and review

Pradeep Kamboj, Mayukh Mukherjee, Jitendre Wadhwani, Rahul Sharma, Mayank Jain, Kunal Arora, Aksha Mohan Garg, Abhay Tanwar, Gaurav Agarwal


Radial club hand also called radial longitudinal deficiency or radial dyspasia is a preaxial longitudinal failure of formation. As the defect is preaxial it is often associated with thumb hypoplasia or anomaly of the radial aspect of the carpus. It is diagnosed clinically and on X-rays. It is frequently syndromic so it is a must to look for associated congenital anomalies by doing a through clinical examination. The frequency of this anomaly is between 1:50000 to 1:100000 live births. The incidence of all radial ray-deficient limbs, including hypoplastic thumbs alone, is approximately 1:30000. The radial deficiency is bilateral in 50% of the cases and the male:female is 3:2. It includes a wide spectrum of disorders that encompass an absent thumb or thumb hypoplasia, a thin first metacarpal and an absent radius. We report here a 1.5 years old child with isolated type IV radial club hand without any restricted range of motion in elbow managed with osteotomy of ulna and centralization of hand.


Radial club hand, Ulnar osteotomy, Hand

Full Text:



Bayne LG, Klug MS. Long term review of the surgical treatment of radial deficiencies. J Hand Surg Am 1987;12:169-70.

Romero R, Athanassiadis AP, Jeanty P. Fetal skeletal anomalies. Radiol Clin North Am. 1989;28:94-5.

Oishi SN, Carter P, Bidwell T. Thrombocytopenia absent radius syndrome: presence of brachiocarpalis muscle and its importance, J Hand Surg Am. 2009;34:1696-8.

Pike JM, Manske PR, Steffen JA. Ulnocarpal epiphyseal arthrodesis for recurrent deformity after centralization for radial longitudinal deficiency. J Hand Surg Am. 2010;35:1755-6.

Kozin SH. Radial Club hand. Available at: Accessed on 25 May 2021.

Bonnet D, Terrett J, Pequignot-Viegas E. Gene localization in 12q12 in Holt-Oram atrio-digital syndrome. Arch Mal Coeur Vaiss. 1995;88:661-4.

Heikel HVA. Aplasia and hypoplasia of the radius. Acta Orthop Scand. 1959;39:1.

Vilkki SK. Distraction and microvascular epiphysis transfer for radial club hand. J Hand Surg Br. 1998;23:445.

Tonkin MA. Radial Longitudinal Deficiency (radial dysplasia, radial club hand). In: Green OP, Hotchkiss RN, Pederson WC, eds. Greens operative hand surgery, 4th edition New York: Churchill Livingstone, 1999;344-6.

Salati SA, Rabah SM. Congenital isolated right radial club hand. Libyan J Med. 2010;5:5090.

Farzan M., Mortazavi SMJ. Congenital radial club hand: result of centralization in 10 cases. Acta Medica Iranica. 2005;43:63-7.

Kozin SH. Upper-extremity congenital anomalies. J Bone Joint Surg Am. 2003;85:1564-76.

Skerik SK, Flatt AE. The anatomy of congenital radial dysplasia. Its surgical and functional implications. Clin Orthop Relat Res. 1969;66:125-43.

Alman BA, Goldberg MJ. Syndromes of Orthopaedic Importance. In: Morrissy RT, Weinstein SL, eds. Lovell and Winters Paediatric Orthopaedics. 5th ed. Lippincott Williams and Wilkins. 2001;287-338.

Goldstein R. Hypoplastic anemia with multiple congenital anomalies (Fanconi’s Syndrome). Am J Dis Child. 1955;89:618-9.

Walia J, Singh R. Radial club hand-A case report. Indian J Orthop. 2006;40:267-8.