Saturday, February 17, 2018

Ulnar Deficiency Follow Up

Hand surgery is a great subspecialty.  I am able to interact and treat many patients and I am rewarded in seeing my patients get better.  However, there is a downside which is that I rarely follow patients long term.  Typically, I am able to see them, provide treatment (whether that be therapy, injection, or surgery) and watch them improve.  And then, typically, I only see them back if another issue arises.

The wonderful aspect of treating kids with birth anomalies is the fact that I am able to follow these children over many years.  We often follow kids through the end of their skeletal growth (i.e., through skeletal maturity).  I am able to develop relationships with the children and their families, understand the real impact of the birth anomaly on the patient, and help families adjust and adapt as needed over the years.

Many years ago, I posted on a child with ulnar deficiency with excellent function: Original Post.  She recently returned and let me know how excited she was to see herself on the blog.  I wanted to update her status with new pictures and x- rays from an 8 year old visit.   She has ulnar deficiency and continues to do well.  This was a routine follow up and there are no major issues.  She functions at a high level.  The elbow is positioned in some flexion, the finger motion is satisfactory and her outstanding shoulder motion helps to compensate for her ulnar deficiency.  This was another gratifying long term follow up visit with a patient who is doing great with ulnar deficiency.

8 year old with left ulnar deficiency and high function.

8 year old with left ulnar deficiency and high function.  She has outstanding shoulder motion.

8 year old with left ulnar deficiency and high function.  She has outstanding shoulder internal rotation motion.

8 year old with left ulnar deficiency and high function.  She can easily get her hand to her mouth but with notable shoulder motion help.

Type 2 Ulnar Deficiency and fusion of the radius to the humerus.

Type 2 Ulnar Deficiency and fusion of the radius to the humerus.
 Charles A. Goldfarb, MD
My Bio at Washington University
congenitalhand@wudosis.wustl.edu