Club hand

Club hand, also known as radial club hand or radial dysplasia, is a congenital malformation characterized by the underdevelopment or absence of the radius (one of the two long bones in the forearm) and deformity of the hand and wrist that makes the hand appear clubbed or curved. This condition can affect one or both hands and varies in severity from mild to severe. Club hand can occur as an isolated condition or as part of a syndrome involving other parts of the body.

Causes

The exact cause of club hand is not fully understood, but it is believed to occur due to a disruption in the normal development of the arm and hand during fetal growth. This disruption can be due to genetic factors, environmental factors, or a combination of both. In some cases, club hand is associated with genetic syndromes such as Holt-Oram syndrome, Fanconi anemia, and VACTERL association.

Symptoms

The primary symptom of club hand is the visible deformity of the hand and wrist. The severity of the deformity can vary, but it typically involves:

• A shortened forearm due to the underdevelopment or absence of the radius.
• A hand that is deviated towards the thumb side (radial deviation).
• Limited motion and functionality of the wrist and hand.
• In some cases, fingers may also be underdeveloped or fused together (syndactyly).

Diagnosis

Diagnosis of club hand is usually made shortly after birth based on physical examination. Imaging tests such as X-rays can help assess the extent of the deformity and plan treatment. In some cases, prenatal ultrasound may detect the condition before birth.

Treatment

Treatment for club hand aims to improve the function and appearance of the hand and arm. The approach to treatment depends on the severity of the deformity and may include:

• Physical therapy and splinting to stretch and strengthen the hand and arm muscles.
• Surgical procedures to correct the bone and soft tissue abnormalities. Surgery may involve reconstruction of the radius, tendon transfers, or wrist fusion.
• In severe cases, prosthetic devices may be recommended to enhance functionality.

Prognosis

The prognosis for individuals with club hand varies depending on the severity of the deformity and the treatment received. Early intervention and appropriate treatment can significantly improve function and appearance of the hand and arm, allowing individuals to lead active lives.

See also

• Congenital limb deformities
• Hand surgery
• Orthopedic surgery