Журнал «Травма» Том 15, №4, 2014

The purpose of the investigation is the analysis of the treatment results of the children with congenital club hand.

Material. The study was based on the treatment results of 35 patients with congenital club hand. The patients are divided in 2 groups. The first group includes 13 patients: 10 with radial clubhand, 3 with ulna clubhand; 6- males, 7- females. The mean age was 7.8 years old. The second group includes 22 patients: 16 with radial clubhand, 6 with ulna clubhand; 7- males, 15 - females. The mean age was 4.6 years old. All of them had anomaly of the hand.

Methods of examination. Physical examining: the average shortening of the forearm for radial clubhand was 4.7 cm in the 1 group, 3.2 cm in the 2 group; the average shortening of the forearm for ulna clubhand was 6.2 cm in the 1 group, 5.3 cm in the 2 group. X-ray parameters before treatment: the average total angle of the deformation for radial clubhand was (117.7 ± 29.0)° in the 1 group, (95.04 ± 20.0)° in the 2 group; the average total angle of the deformation for ulna clubhand was (58.3 ± 7.6)° in the 1 group, (51.4 ± 14.4)° in the 2 group. The functional examination of the upper extremity conducted using QUEST (Quality of Upper Extremity Skills Test).

Methods of the treatment. 13 patients for the first group had the 22 surgical treatment: centralization or radialization of the wrist, distraction lengthening of the forearm and the correction of the ulna and radius deformation. 22 patients of the second group had the 85 combination surgery of the forearm and the hand: soft- tissue distraction before centralization of the hand using the original monolateral multifunctional external fixator and the correction osteotomy of the ulna; the resection of the radial anlage, distraction lengthening of the forearm and the correction of the ulna and radius deformation, syndactyly release, pollicization, opponensplasty.

Results. After treatments all of X-ray parameters changed. The average total angel of the deformity for radial clubhand is (57,3 ± 36,3)° in the 1 group and (17,2 ± 13,3)° in the 2 group. The average total angel of the deformity for ulna clubhand is (18,3±2,9)° in the 1 group and (14,3 ± 5,3)° in the 2 group.

The best functional treatment results in 2. 2 times have the patients of the second group who had the combination surgery of the forearm and the hand.

Conclusions. The children with congenital radial and ulna clubhand need the combination surgeries of the forearm and the hand. The combination surgeries have the more functional results.