Amniotic Constriction Band- how we can help function

Amniotic constriction band is a common condition which typically involves more than one extremity.  While the belly and face can be involved in rare patients, the arms and legs are the classic sites.  Every child with amniotic band is different.  Totally.  Sometimes, physicians refer to it as a syndrome but that is not really accurate- it is a random pattern of constriction rings, […]

Fixators for Lengthening. Fun?

External fixators are devices that rest outside of the skin.  They can be used to stabilize broken bones (although not used very often for this purpose today) or to correct a short or angled extremity/ bone.  We use fixators to lengthen small bones such as the thumb to allow pinch or to grow the forearm […]

Severe Radial Deficiency, Before and After

I have posted numerous times on radial longitudinal deficiency.  The birth anomaly is common in my practice and I have been fortunate to meet many great kids and families with radial deficiency.  A few posts can be seen HERE. Early in my career, as influenced by my training, most patients with radial deficiency were treated with […]

Radial Deficiency- Every Child is Unique

Every child with radial longitudinal deficiency is unique and therefore is treated individually. While there are general principles in treatment and these principles may be applied to most children, we begin care by working to understand each child and each family. In a child with radial longitudinal deficiency presenting for evaluation, we consider many factors as we […]

Type 2 Radial Longitudinal Deficiency

Bayne and Klug wrote what is now a classic scientific article on radial longitudinal deficiency in 1987 Classic Article.  This article described 4 types of radial longitudinal deficiency: Type 1- Short distal radiusType 2- Radius in miniature (short proximal and distal)Type 3- Absent distal radiusType 4- Absent entire radius More recently, we added a Type 5- […]

Bone/ cartilage tumors/ MHE (multiple hereditary exostoses)

Multiple hereditary exostoses (MHE) is a genetic condition in which a patient has many bone/ cartilage tumors.  It is also know as multiple hereditary osteochondromatosis.  These are “tumors”- unregulated growths- but these are not malignant tumors (since they don’t go anywhere- they don’t metastasize). This condition differs from a condition I have previously posted: isolated osteochondroma. […]

Symbrachydactyly, now what?

I have posted on symbrachydactyly several times in the past.  https://congenitalhand.wustl.edu/search/label/Symbrachydactyly There are, by different symbrachydactyly classifications, 7 types: short finger cleft type (thumb and small finger present) peromelic (nubbins) monodactyly (only the thumb present) wrist bones present (but nothing more distal) wrist bones absent (ie, arm ends at the end of the forearm) transforearm […]

Recurrent Radial Longitudinal Deficiency

The best treatment for the forearm/ wrist deformity in Radial Longitudinal Deficiency remains uncertain as I have previously outlined in a previous blog posting https://congenitalhand.wustl.edu/2012/05/form-and-function-in-radial-deficiency.html .  The problem is that the anatomical deficiencies in Radial Longitudinal Deficiency limit our ability to sufficiently correct the underlying deformity.  There is a lack of muscles to extend (bend back) the wrist and a […]

Finger Lengthening

Lengthening a finger or thumb may be a good treatment option for a number of conditions including symbrachydactyly, constriction band syndrome, and ulnar deficiency.  Essentially any congenital or traumatic condition that leads to a shortened digit (or digits) may interfere with function.  If lengthening that digit will help pinch or large object grasp (i.e., soda […]

External Fixator- Piece of Cake

There are two different types of fixators that we use in the care of kids with upper extremity differences.  One is a unilateral frame and is just on one side of the bone.  It usually has 4 pins sticking into the bone and a rail outside the skin.  It is useful for lengthening bone- done […]