Retrospective Review of the Treatment of Radial Club Hands at Two Tertiary Centres in Côte d'Ivoire

Abstract

 Background: The treatment of radial club hands is difficult and requires staged procedures in specialised centres.

Objective: To report the Ivorian experience with this condition.

Settings: Yopougon Teaching Hospital, Abidjan and "Don Orione” Centre for the Crippled, Bonoua.

Subjects and Methods: The management of 22 club hands in a cohort of 14 patients (nine boys and five girls) aged 14 days - 12 years (mean age, 3.3 years + 4.3) over a 14-year period, was reviewed. Three of the children were neonates, six were aged one month-one year while the rest were older than one year. The lesions were classified according to the method described by Bayne & Klug. Theywere all treated surgically with preoperative physical care in the neonates and infants. Functional and aesthetic results were assessed by using the criteria of Cattaneo etal at a mean follow up period of 2.4 years.

Results: Twelve of the children had Bayne type IV deformity, nine type I and one type II. Eleven children with type IV deformity were treated by centralization with ulnar osteotomy and one child with type IV, by centralization alone. Complications included one case of wound infection, two with haematomas and two pin migrations without recurrence of wrist deviation. According to Cattaneo et al's staging score, the hand function was good in 18 cases and average in four; aesthetic result was good in 12 hands, average in six and poor in four.

Conclusion: The treatment provided satisfactory results for the children and their families with the result that there has since been an increase in the number of club hands referred to the hospital. 

Key words: Congenital radial club hand, treatment, children