Recurrence rate after radial club hand surgery in long term follow up

BACKGROUND: Radial club hand includes wide spectrum of malformations that involve radial side of forearm. Conservative treatments are recommended to the milder types and surgical interventions specially centralization for the severe forms. Recurrence after centralization is one of the challenging problems in this anomaly. In this study, we assessed the recurrence rate of centralization in radial club hand surgery in long term follow up. METHODS: In this retrospective study, we reviewed the records and radiographies of 9 patients with radial club hand who underwent centralization to correct the deformity in the hand surgery department. Patients’ age, type of the thumb anomaly, associated anomalies in other systems, involved side, type of radial club hand, hand-forearm angle preoperative, post operative and in the last follow up visit, and centralized wrists motion range in the final follow up visit were all assessed and reported. RESULTS: Eleven cases of radial club hand in nine patients underwent centralization. Mean age at the time of the centralization was 17 (6-72) months and mean follow up was 90 (48-170) months. Preoperative hand-forearm angle was 75 (30-110) degrees, immediate postoperative angle was 25 (15-35) degrees and in the last follow up visit it was 52 (40-60) degrees. The amount of correction was 66% and loss of correction in long term was 54%. CONCLUSION: Centralization still can be a standard procedure in treatment of patients with radial club hand with acceptable results.