Dr Steve Carter


Radial Club Hand Corrections

What are radial club hand corrections?

Radial club hand, or radial dysplasia, is a congenital hand defect that is characterised by abnormalities in the radial (or thumb) side of the hand where the radius is either too short or missing. This causes the arm to bend at the wrist and, in some cases, a fully developed thumb could be missing as well.

Radial club hand can occur in several degrees of severity, and the more serious cases require surgery to correct. Radial club hand corrections are the surgeries performed by Dr Carter at The Cape Hand Clinic to help children suffering from radial dysplasia.

Radial club hand often occurs at random, or sporadically, and specific causes for the condition is not known. In some cases, however, the birth defect can be linked to other genetic problems and can also be hereditary. It may also occur bilaterally involving both hands. Radial Club hands are often associated with other congenital abnormalities such as the so-called VATER syndrome. Children with Radial Club hands need to be carefully screened to rule out problems with their heart or GIT, vertebral and anorectal problems.

How are radial club hand corrections performed?

There are four types of radial club hand deformities that can affect children, namely type I, type II, type III and type IV. While type I is the least severe form of radial club hand and presents itself as a slight bend in the wrist, the more severe types can impact a child's use of their hands significantly.

In type II and above, the radius of the hand is short or missing and causes the hand to bend in a way that prevents normal movement. Sometimes, due to the bend, the thumb of the affected hand is also underdeveloped or completely missing too.

In these cases, Dr Carter will examine the hands through a series of tests and X-rays to determine what kind of surgery is needed. The child will then be operated on in various stages to gradually reconstruct the affected hand. This usually takes place when the child is between 1 and 2 years old and involves correcting the bend in the wrist, repositioning the hand and reconstructing the thumb in cases where the thumb was underdeveloped or missing. Because surgery is performed while a child is still developing, the radial dysplasia could continue as they get older. Therefore, follow up visits are necessary.