Microsurgical MTP

Introduction: In the treatment of radial dysplasia or radial club hand the surgical methods are changing from centralization to microsurgical bone and joint transfer to stabilize the hand with a growing autogenous bone. Materials: Thirty-four radial club hand extremities have been treated with a microsurgical metatarsal bone and joint transfer. Patients’ age has been optimally between 2 and 5 years at the time of operation. Methods: The operation is done in 2 stages. (1) Preoperative distraction and alignment of the hand using the speed of 0.5 mm/day. (2) After about 6 to 7 weeks, a microvascular transfer of second metatarsophalangeal (MTP) joint and metatarsal bone has been done. Results and Conclusions: In a group of 19 patients with long-term follow-up, the growth of the forearm has occurred well without additional growth disturbance. Also, the wrist alignment has been adequate in long term or only 29 degrees of radial deviation has returned. These patients gain best with the new mobile wrist. The wrist motion will be typically from 20° extension to 80° flexion. With the growing experience, the results have got even better and the technique has become refined.