Treatment of traumatic radial clubhand deformity with bone loss using the Ilizarov apparatus.

Abstract

Radial clubhand deformity secondary to atrophic nonunion of an open distal radius fracture with bone loss is a challenging reconstructive problem. Two patients with this deformity had staged reconstruction using the Ilizarov apparatus. After gradual realignment of the distal radius metaphyseal fragment, a proximal to distal bone transport of the radial shaft was done. At completion of the bone transport, the docking site was augmented with autologous iliac crest bone graft. Both patients achieved radiographic union at the proximal and distal ends of the bone transport site and were satisfied with the outcome. At 3 years followup, full finger and elbow mobility were maintained. The wrist had improved appearance with limited painless mobility. Posttraumatic radial club hand deformities with associated bone loss can be treated successfully with staged reconstruction using the Ilizarov apparatus and methodology.