Jaroslaw M Deszczynski1,2, Tomasz Albrewczynski2, Claire Shannon3, Dror Paley3. 1. Department of Orthopedics and Rehabilitation, Warsaw Medical University, 02-091 Warsaw, Poland. 2. Paley European Institute, 02-972 Warsaw, Poland. 3. Paley Orthopedic and Spine Institute, 901 45th St. Kimmel Building, West Palm Beach, FL 33407, USA.
Abstract
(1) Background: Patients treated with the two previous generations of ulnarization developed a bump related to the ulnar head becoming prominent on the radial side of the hand. To finally remedy this problem, a third generation of ulnarization was developed to keep the ulnar head contained. While still ulnar to the wrist center, the center of the wrist remains ulnar to the ulnar head, with the ulnar head articulating directly with the trapezoid and when present the trapezium. (2) Methods: Between 2019 and 2021, 22 radial club hands in 17 patients were surgically corrected with this modified version of ulnarization. (3) Results: In all 17 patients, the mean HFA (hand-forearm-angle) correction was 68.5° (range 12.2°-88.7°). The mean ulna growth was 1.3 cm per year (range 0.2-2 cm). There were no recurrent radial deviation deformities more than 15° of the HFA. (4) Conclusions: This new version of ulnarization may solve the problem of the ulna growing past the carpus creating a prominent ulnar bump. The results presented are preliminary but promising. Longer-term follow-up is needed to fully evaluate this procedure.
(1) Background: Patients treated with the two previous generations of ulnarization developed a bump related to the ulnar head becoming prominent on the radial side of the hand. To finally remedy this problem, a third generation of ulnarization was developed to keep the ulnar head contained. While still ulnar to the wrist center, the center of the wrist remains ulnar to the ulnar head, with the ulnar head articulating directly with the trapezoid and when present the trapezium. (2) Methods: Between 2019 and 2021, 22 radial club hands in 17 patients were surgically corrected with this modified version of ulnarization. (3) Results: In all 17 patients, the mean HFA (hand-forearm-angle) correction was 68.5° (range 12.2°-88.7°). The mean ulna growth was 1.3 cm per year (range 0.2-2 cm). There were no recurrent radial deviation deformities more than 15° of the HFA. (4) Conclusions: This new version of ulnarization may solve the problem of the ulna growing past the carpus creating a prominent ulnar bump. The results presented are preliminary but promising. Longer-term follow-up is needed to fully evaluate this procedure.
Authors: James J McCarthy; Scott H Kozin; Christopher Tuohy; Emilie Cheung; Richard S Davidson; Kenneth Noonan Journal: J Pediatr Orthop Date: 2009 Oct-Nov Impact factor: 2.324
Authors: George R F Murphy; Malcolm P O Logan; Gill Smith; Branavan Sivakumar; Paul Smith Journal: J Bone Joint Surg Am Date: 2017-12-20 Impact factor: 5.284