Clubhand

Clubhand, 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 club-like. This condition can affect one or both hands and varies in severity from mild to severe. Clubhand is often diagnosed at birth or through prenatal ultrasound.

Causes

The exact cause of clubhand is not fully understood, but it is believed to be related to genetic factors or disruptions in fetal development during pregnancy. In some cases, it is associated with genetic syndromes such as Holt-Oram syndrome, Fanconi anemia, and VACTERL association.

Symptoms

Symptoms of clubhand can vary significantly but typically include:

• A noticeable deformity of the wrist and hand
• Shortening of the forearm
• Limited motion in the affected wrist and hand
• Weakness in the hand and arm

In severe cases, the hand may be positioned at a right angle to the forearm, and there may be significant functional limitations.

Diagnosis

Diagnosis of clubhand is usually made at birth based on physical examination. Further assessment through X-rays can help determine the extent of the bone abnormalities. In some cases, additional imaging tests such as MRI or ultrasound may be used to assess the soft tissues and vascular structures.

Treatment

Treatment for clubhand aims to improve the function and appearance of the hand and arm and may include:

• Physical therapy and occupational therapy to improve strength and flexibility
• Splinting or casting to gradually stretch the soft tissues and correct the deformity
• Surgery to correct bone abnormalities, lengthen the forearm, and improve hand position. Surgical options may include radial osteotomy, tendon transfers, and in severe cases, pollicization (creation of a thumb from an existing finger).

Prognosis

The prognosis for individuals with clubhand varies depending on the severity of the condition and the treatment received. Early intervention and appropriate treatment can significantly improve function and appearance of the hand and arm. However, some degree of limitation may remain, especially in more severe cases.

See also

• Congenital limb deformities
• Orthopedic surgery
• Physical therapy