Radial longitudinal deficiency, also known as radial club hand, is a congenital deformity of the upper extremity which can present with a spectrum of upper limb deficiencies. The typical hand and forearm deformity in such cases consists of significant forearm shortening, radial deviation of the wrist and hypoplasia or absence of a thumb. Treatment goals focus on the creation of stable centralized and functionally hand, maintenance of a mobile and stable wrist and preservation of longitudinal forearm growth. Historically centralization procedures have been the most common treatment method for this condition; unfortunately centralization procedures are associated with a high recurrence rate and have the potential for injury to the distal ulnar physis resulting in a further decrease in forearm growth. Here we advocate for the use of a vascularized second metatarsophalangeal joint transfer for stabilization of the carpus and prevention of recurrent radial deformity and subluxation of the wrist. This technique was originally described by the senior author in 1992 and he has subsequently been performed in 24 cases with an average of 11-year follow-up. In this paper we present an overview of the technique and review the expected outcomes for this method of treatment of radial longitudinal deficiency.
Forearm/abnormalities/*surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Joints/*transplantation ; Metatarsophalangeal Joint/surgery ; Radius/abnormalities/*surgery

Radial longitudinal deficiency, also known as radial club hand, is a congenital deformity of the upper extremity which can present with a spectrum of upper limb deficiencies. The typical hand and forearm deformity in such cases consists of significant forearm shortening, radial deviation of the wrist and hypoplasia or absence of a thumb. Treatment goals focus on the creation of stable centralized and functionally hand, maintenance of a mobile and stable wrist and preservation of longitudinal forearm growth. Historically centralization procedures have been the most common treatment method for this condition; unfortunately centralization procedures are associated with a high recurrence rate and have the potential for injury to the distal ulnar physis resulting in a further decrease in forearm growth. Here we advocate for the use of a vascularized second metatarsophalangeal joint transfer for stabilization of the carpus and prevention of recurrent radial deformity and subluxation of the wrist. This technique was originally described by the senior author in 1992 and he has subsequently been performed in 24 cases with an average of 11-year follow-up. In this paper we present an overview of the technique and review the expected outcomes for this method of treatment of radial longitudinal deficiency.
Forearm/abnormalities/*surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Joints/*transplantation ; Metatarsophalangeal Joint/surgery ; Radius/abnormalities/*surgery

During imaging studies or surgical procedures, anomalous forearm and wrist muscles are occasionally encountered. Among them, the flexor carpi radialis brevis is very rare. Because the trend is growing toward treating distal radius fractures with volar plating, the flexor carpi radialis brevis is worth knowing. Here, we report two cases with a review of the literature.
Female ; Forearm/*abnormalities ; Fractures, Comminuted/surgery ; Humans ; Middle Aged ; Muscle, Skeletal/*abnormalities ; Radius Fractures/surgery ; Ulna Fractures/surgery ; Wrist/*abnormalities

Forearm ; Humans ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tongue ; abnormalities ; injuries ; surgery

OBJECTIVETo explore the biological reaction of swine acellular dermal matrix as a filling material for body surface deformity.

METHODSXenogenic acellular dermal matrix was implanted into the hypoderm of rabbits. The implants were measured and observed with pathological and transmission electron microscopic technique at regular times. The results were compared with implantation of autologous dermis and swine dermis.

RESULTSThe implanted xenogenic acellular dermal matrix and autologous dermis had slight inflammatory reaction. At 2 weeks there were fibroblasts and capillaries in the implants. The absorptivity of the xenogenic acellular dermal matrix was lower than the swine dermis. The xenogenic acellular dermal matrix was used in 2 clinical cases and obtained good result.

CONCLUSIONThe xenogenic acellular dermal matrix is an ideal material with good compatibility feature and low absorptivity.

Animals ; Biocompatible Materials ; metabolism ; Cleft Lip ; surgery ; Dermis ; physiology ; transplantation ; ultrastructure ; Female ; Forearm ; abnormalities ; surgery ; Graft Survival ; physiology ; Humans ; Male ; Microscopy, Electron ; Rabbits ; Skin Transplantation ; methods ; Subcutaneous Tissue ; surgery ; Swine ; Transplantation, Heterologous