Hand function of patients with radius dysplasia

1
Hand Function of Patients with Radius
Dysplasia Schmidt M., Gradl B., Weigel G.,
Mickel M., Girsch W.
PURPOSE Radius dysplasia is a longitudinal
failure of formation affecting the upper
extremity. Besides being cosmeticaly unsightly it
considerably impaires hand function. The aim of
our study was to objectify hand function of
patients with radius dysplasia and to assess
effectiveness of surgical correction. Furthermore
we compared different types of treatment
concerning functional and radiographic parameters.

• CENTRALISATION
• Resection of central
• carpal bones
• Distal ulna positioned
• into carpal notch
• ? wrist-arthrodesis

• RADIALISATION
• No resection of carpal bones
• Radial carpus positioned over
• distal ulna tendon transfers
• ? preserved wrist mobility

PATIENTS METHODS 9 Patients / 14 Radius
Dysplasias Cons. Conservative therapy
(splinting)
X-ray criteria of Manske a Radial deviation ß
Ulna bowing d Hand-forearm position
Millesi Hand Test ROM, grip strength, 2-PD,
Pick-up test Normal hand 100
Jebsen-Taylor Test Simulated
everyday-situations Time-comparison
with unimpaired subjects
RESULTS
Conservatively treated patient
plt0.05
Radius dysplasia results in severe limitation
of hand function at 42 of normal values
(Millesi score). Extremities treated with
Radialisation showed a more neutral
hand-forearm alignment than Centralisation. The
patients treated by splinting exhibited
impressive functional capabilities despite
their severe deformity.
Centralisation Radialisation
DISCUSSION Our data gave the impression that
Radialisation results in higher hand function and
a more neutral hand forearm alignment than
Centralisation. Compared to the conservatively
treated extremities surgery is most important for
providing additional extremity length and
therefore improving overall extremity performance.
Bilateral Radialisation
Corresponding author Univ.-Doz. Dr. Werner
Girsch, werner.girsch_at_oss.at Orthopedic Hospital
Speising, A-1134 Vienna, Speisingerstr. 109