eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Ulnar Clubhand: Workup

Author: Minoo Patel, MBBS, MD, MS, FRACS, Senior Lecturer, Monash University, Melbourne, Australia; Consulting Adult/Pediatric Orthopedic Surgeon, Department of Orthopedic Surgery, Monash Medical Center, Melbourne, Australia
Coauthor(s): John Herzenberg, MD, FRCSC, Professor, Department of Orthopedic Surgery, Associate Professor, Department of Pediatrics, University of Maryland Medical School, Codirector of International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore
Contributor Information and Disclosures

Updated: Oct 19, 2007

Workup

Imaging Studies

  • Radiographic evaluation of the elbow, forearm, wrist, and hand: Serial radiographs can be useful in assessing the degree and course of the aplasia.
  • Magnetic resonance imaging (MRI): MRI can be used to delineate noncalcified tissues such as the fibrocartilaginous anlage. This modality is also useful for studying the joint surfaces in the largely unossified cartilaginous articulations.

Other Tests

  • All affected patients should undergo a detailed evaluation by a hand and upper limb therapist to assess hand function. Ongoing evaluation during treatment is important to avoid restriction of hand and elbow function (see Complications). In addition, appropriate genetic evaluation and counseling for individuals with syndromic ulnar aplasia is important in certain instances.

More on Ulnar Clubhand

Overview: Ulnar Clubhand
Workup: Ulnar Clubhand
Treatment: Ulnar Clubhand
References

References

  1. Swanson AB, Tada K, Yonenobu K. Ulnar ray deficiency: its various manifestations. J Hand Surg [Am]. Sep 1984;9(5):658-64. [Medline].

  2. Tetsworth K, Krome J, Paley D. Lengthening and deformity correction of the upper extremity by the Ilizarov technique. Orthop Clin North Am. Oct 1991;22(4):689-713. [Medline].

  3. Paley D, Herzenberg JE. Distraction treatment of the forearm. In: Buck-Gramcko D, ed. Congenital Malformations of the Hand and Forearm. London, UK: Churchill Livingstone; 1998:90-2.

  4. El Hassan B, Biafora S, Light T. Clinical manifestations of type IV ulna longitudinal dysplasia. J Hand Surg [Am]. Sep 2007;32(7):1024-30. [Medline].

  5. Foucher G. [Toe transplantation in congenital malformations of the hand] [French]. Bull Acad Natl Med. Nov 1997;181(8):1737-44; discussion 1744-5. [Medline].

  6. Kakarala G, Kavarthapu V, Lahoti O. Distraction osteogenesis to improve limb function in congenital bilateral humeroradioulnar synostosis. Acta Orthop Belg. Dec 2006;72(6):765-8. [Medline].

  7. Malpas T, Anderson N, Langley S. Ulnar club-hand and constriction-ring syndrome. Pediatr Radiol. 1995;25(3):233-4. [Medline].

  8. Minguella-Solá J, Cabrera-González M, Escolá-Teixidó J. [Radial club-hand and contralateral pre-axial polydactyly and ulnar club-hand and contralateral post-axial polydactyly. Report of 2 unusual cases] [Spanish]. An Esp Pediatr. Jul 1999;51(1):68-70. [Medline].

  9. Saffar P. Ulna oblique osteotomy for radius and ulna length inequality: technique and applications. Tech Hand Up Extrem Surg. Mar 2006;10(1):47-53. [Medline].

  10. Wang AA, Hutchinson DT. Use of the elbow compass universal hinge in pediatric patients. J Pediatr Orthop. Jan-Feb 2006;26(1):58-60. [Medline].

Further Reading

Keywords

ulnar dysplasia, ulnar aplasia, ulnar deficiencies of the forearm, split hand, split foot, polydactyly, camptodactyly, focal dermal hyperplasia, Goltz syndrome, Goltz-Gorlin syndrome, skin atrophy, anal papillomata, vulval papillomata, lip papillomata, microphthalmia, iris coloboma, mental retardation, mammary gland aplasia syndrome

Contributor Information and Disclosures

Author

Minoo Patel, MBBS, MD, MS, FRACS, Senior Lecturer, Monash University, Melbourne, Australia; Consulting Adult/Pediatric Orthopedic Surgeon, Department of Orthopedic Surgery, Monash Medical Center, Melbourne, Australia
Minoo Patel, MBBS, MD, MS, FRACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, AO Foundation, Australian Association of Surgeons, Australian Medical Association, Australian Orthopaedic Association, Orthopaedic Research Society, Orthopaedics Overseas, Pediatric Orthopaedic Society of North America, and Royal Australasian College of Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

John Herzenberg, MD, FRCSC, Professor, Department of Orthopedic Surgery, Associate Professor, Department of Pediatrics, University of Maryland Medical School, Codirector of International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore
John Herzenberg, MD, FRCSC is a member of the following medical societies: American Academy for Cerebral Palsy and Developmental Medicine, American Academy of Orthopaedic Surgeons, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Medical Editor

Joseph E Sheppard, MD, Director of Hand and Upper Extremity, Associate Professor, Department of Orthopedic Surgery, University of Arizona
Joseph E Sheppard, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Society for Surgery of the Hand, Southern Orthopaedic Association, and Western Orthopaedic Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center, Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

 
 
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