Clinical and Radiological Outcomes of Centralization of Radial Club Hand
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|ClinicalTrials.gov Identifier: NCT03432052|
Recruitment Status : Unknown
Verified February 2018 by El-Taher Alaa Eldin Ahmed Eid, Assiut University.
Recruitment status was: Not yet recruiting
First Posted : February 13, 2018
Last Update Posted : February 13, 2018
|Condition or disease||Intervention/treatment|
|Radial Clubhand||Procedure: centralization|
Radial club hand is a deficiency along the radial side of the extremity. Although considerable forearm and hand anomalies are the classic findings, proximal deficiencies also can occur throughout the arm and shoulder girdle. The elbow abnormalities can include deficiences of the olecranon, capitellum, coronoid fossa, and medial epicondyle.
In 1733, Petit first described radial club hand in an autopsy of a neonate with bilateral club hands and absent radii.
Initial surgical treatment of radial club hand involved an ulnar osteotomy to correct the bow, along with splitting of the distal ulna for insertion of the carpus. Reconstruction of the radius with a bone graft to support the carpus was reported in the 1920s, and non-vascularized epiphyseal transfer was reported in 1945. Results of these procedures were disappointing. They had multiple causes of failure, including disruption of the ulnar growth plate and subsequent increase in limb-length discrepancy, inadvertent ankylosis or arthrodesis of the wrist and loss of motion, and failure of the transplanted bone to grow, with eventual loss of radial support.
Centralization of the carpus on the distal ulna has emerged as the preferred surgical technique for correcting radial clubhand.in 1893, Sayre described it consisting of seating the distal ulna into a surgically created carpal notch. Pioneers in congenital hand surgery developed the basis for this procedure. Numerous modifications have been described to obtain or maintain correction of the wrist on the ulna.
Wrist centralization involves aligning the distal ulna with the middle finger metacarpal and passing a large Kirschner wire or a a small Steinmann pin through the middle finger metacarpal , carpus ,and ulna for temporary stability. This is followed by soft tissue balancing in order to counteract the volar and radial directed force vectors consisting of reefing the ulnocarpal wrist capsule and transferring the extensor carpi ulnaris muscle distally and flexor carpi ulnaris muscle dorsally on the wrist.
|Study Type :||Observational|
|Estimated Enrollment :||10 participants|
|Official Title:||Clinical and Radiological Outcomes of Centralization as a Surgical Management for Radial Club Hand|
|Estimated Study Start Date :||March 1, 2018|
|Estimated Primary Completion Date :||March 1, 2019|
|Estimated Study Completion Date :||April 1, 2019|
- Procedure: centralization
Wrist centralization involves aligning the distal ulna with the middle finger metacarpal and passing a large Kirschner wire or a small Steinmann pin through the middle finger metacarpal, carpus, and ulna for temporary stability. This is followed by soft tissue balancing in order to counteract the volar and radial directed force vectors consisting of reefing the ulnocarpal wrist capsule and transferring the extensor carpi ulnaris muscle distally and flexor carpi ulnaris muscle dorsally on the wrist.
- recurrence of wrist deformity [ Time Frame: at least 2 years of follow up ]HFA more than 10 degrees as Vilkki HWO severity grading for radial dysplasia consider 10 degrees is the cut-off point for mild deformity.The hand-forearm-angle (HFA) is defined as the acute intersecting angle between the longitudinal axis of the third metacarpal and a line drawn perpendicular to the distal physis of the ulna
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03432052
|Contact: El-Taher Alaa eid, Residentemail@example.com|
|Contact: Tarek Abdallah elgammal, professor||01005229293||Tarek.firstname.lastname@example.org|