gms | German Medical Science

Objectives/Interrogation: Radial longitudinal deficiency (RLD) includes bone, musculotendinous and neurovascular abnormalities of multifactorial etiology of the radial side of the upper extremity. Treatment includes improving the length of the limb, the appearance and functioning of the hand. The aim of the work is to show the experience in a series of patients attended in the last 15 years and describe clinical and radiological results.

Methods: Retrospective study of patients with RLD between 2000 and 2016. Variables were analyzed and age associations were identified at the time of surgery, sex, laterality, type of deformity according to the modified Bayne-Klug classification [1], surgical technique, physis damage, associated diseases, functional and radiological results with degree of satisfaction, clinical position and radiological hand forearm angle.

Results: 47 cases of 65 met the inclusion criteria. The average age of surgery was 19 months, 61% female, 64% right hand. According to classification, type IV was 60%, type III 19%, type 0 in 17% and type I in 4%. 11% VACTERL association. The intervention performed was centralization 72,3%, radialization 8,5% and one case of lengthening. Ulna osteotomy was performed in 55,3%. There was damage of the physis in 31%. The postoperative radiological position was neutral in 48,9%.

Conclusions: In patients with centralization at 1 year, a good clinical and radiological correction were observed (Figure 1 [Fig. 1]), however the result worsened in some patients with longer follow-up (Figure 2 [Fig. 2]). Preoperative, one and five years follow-up The management of soft tissues prior to centralization is believed to give better results. The use of intramedullary nail from the ulna to the carpus could be associated with damage of the distal ulna.