CONGENİTAL FOREARM DEFORMITIES

Congenital upper extremity anomalies in very different forms are seen alone or as part of a syndrome (a set of findings that seem unrelated, but show themselves as a single phenomenon when combined).

While the forearm consists of two separate bones called the radius and ulna. The forearm articulates with the wrist bones below and with the arm bone called the humerus above. Among the most common congenital forearm deformities, there are Club Hand deformities (radial and ulnar club hand), where the radius or ulna bones are insufficiently developed, Madelung's deformity, and cases where the radius and ulna are fused to each other at various levels (synostosis). Apart from these, developmental delays caused by premature closure of growth cartilages, joint stiffness called arthrogryposis and conditions with movement defects, and phocomelia cases where the hand starts directly from the arm without the absence of the entire forearm are the other main deformities. In addition, developmental deformities that are not congenital but develop secondary to traumas at a very young age are among the challenging cases that we hand surgeons face.

Over time, these bone abnormalities can affect the joints, muscles and skinduring the growth process of the individual. We call these limitations ‘’contracture’’.

As Hand Surgeons, we would like to follow up children with congenital upper extremity anomalies from the earliest possible period, although we start to operate them around 10 months-1 years of age, except in very special circumstances. We should definitely evaluate babies with forearm deformities together with our physiotherapist before surgery. While waiting for the surgery time in a significant part of these patients, further progression of the deformity can be reduced by using some splints. Thus, the result of the surgery will be more successful.

The procedures to be performed in the surgery are decided according to which area exactly the deformity concerns, the severity of the deformity and the structures other than bones are affected. Depending on the patient's current problem, surgical techniques such as bone lengthening with external fixator, bone shaping interventions (osteotomy), tendon lengthening-shortening, contracture releasing are applied. Since patients are just at the beginning of their development ages, other complementary surgeries may be needed in the future. Therefore, long-term follow-up after the surgery and close communication between the doctor-family-physiotherapist are very important for ultimate success.