Radial clubhand (radial deficiency)

Last revised by Ashesh Ishwarlal Ranchod on 23 Oct 2023

Radial clubhand is a rare congenital birth disorder characterized by an absent thumb and a perpendicular relationship between wrist and forearm.

Rare. Noted in around 1: 55,000 births. Bilateral up to 72% of cases.

Patients present with a perpendicular relationship of the wrist to the forearm. They often have an absent or hypoplastic thumb.

No known genetic cause has been identified yet. Possible causation is suspected in fibroblast growth factor function and sonic hedgehog gene. Associated with thrombocytopenia-absent radius (TAR) syndrome, Fanconi anemia, VATER and VACTERL syndrome.

The entire radius bone and often the thumb is absent on X-ray.

Initial treatment is passive stretching, splinting and manipulation and should commence soon after birth.

Surgical procedures such as hand centralisation can be performed to improve functional outcomes. Operative interventions are typically performed at 6-12 months of age.

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