Dr. L. Santecchia
Radial Club Hand (RCH), aka Radial Dysplasia 120° Heikel Type IV, with absent thumb (Blauth V).
Skin fasciocutaneous Evans flaps (Mickey Mouse Flap).
To allow easier centralisation, the first branch of the carpus (scaphoid and semilunar) was partially removed, and the distal ulna was shortened by osteotomy and pinning with Kirschner Wire 1.5. Brachioradialis, ECRB and ECRL tendon transfers to the hamate. Fisches placement on 5th and 4th metacarpals and on the proximal metaphysis of the ulna.
Finally, the arrangement of Orthofix biplanar multiarticular bone distractor device.
Once the centralisation has been achieved (it takes approx. 40-45 days and 4-6 months for bone stabilization), the device will be removed, and another distractor will definitely be inserted to lengthen the ulna. At the same time, the 2nd finger will be pollicised, according to Ezaki
The situation at the end of the first surgical intraoperative step
Once centralisation is achieved (it takes approximately 40-45 days and 4-6 months for bone stabilisation), the devices will be removed, and the 2nd finger will be pollicised, according to Ezaki.
The patient at the end of the first surgical phase the day of discharge from the hospital.
The hexagonal screws of the distractors are rotated one turn per day, which corresponds to 1 mm of advancement – bone elongation.
