TY - JOUR

T1 - Ulnar dimelia - a review of 24 cases

AU - Winge, Mona I

AU - Guéro, Stéphane

AU - Zavarukhin, Vladimir

AU - Paavilainen, Pasi

AU - Baldrighi, Carla

AU - Kjørup, Anders

AU - Hülsemann, Wiebke

PY - 2023/12

Y1 - 2023/12

N2 - Ulnar dimelia is a very rare unilateral congenital upper limb anomaly (CULA) affecting the whole extremity. Treatment remains difficult because of the complexity and multi-level involvement. Twenty-four cases with duplicated ulna, absent radius and polydactyly from seven European centres were reviewed according to a structured list of parameters. At first consultation, median age 8 months (1-178), the shoulder movement was good in 17 patients or poor in six, and the median passive elbow range of motion was 20° (0°-90°). The resting wrist position was flexed in 22/24 patients. Following stretching and splinting, elbow surgery included resection of the lateral proximal ulna in 11 patients and muscle transfers in six to improve passive movement and increase active elbow motion, respectively. Tendon transfers were performed in eight wrists and a pollicization or pseudo-pollicization in 23 patients. Overall, patients demonstrate acceptable function postoperatively. Guidelines for treatment of this severe CULA are presented.Level of evidence: IV.

AB - Ulnar dimelia is a very rare unilateral congenital upper limb anomaly (CULA) affecting the whole extremity. Treatment remains difficult because of the complexity and multi-level involvement. Twenty-four cases with duplicated ulna, absent radius and polydactyly from seven European centres were reviewed according to a structured list of parameters. At first consultation, median age 8 months (1-178), the shoulder movement was good in 17 patients or poor in six, and the median passive elbow range of motion was 20° (0°-90°). The resting wrist position was flexed in 22/24 patients. Following stretching and splinting, elbow surgery included resection of the lateral proximal ulna in 11 patients and muscle transfers in six to improve passive movement and increase active elbow motion, respectively. Tendon transfers were performed in eight wrists and a pollicization or pseudo-pollicization in 23 patients. Overall, patients demonstrate acceptable function postoperatively. Guidelines for treatment of this severe CULA are presented.Level of evidence: IV.

KW - Humans

KW - Hand Deformities, Congenital/surgery

KW - Ulna/surgery

KW - Polydactyly/surgery

KW - Wrist Joint

KW - Upper Extremity

KW - Radius/abnormalities

U2 - 10.1177/17531934231196418

DO - 10.1177/17531934231196418

M3 - Review article

C2 - 37684016

VL - 48

SP - 1126

EP - 1135

JO - Journal of Hand Surgery: European Volume

JF - Journal of Hand Surgery: European Volume

SN - 1753-1934

IS - 11

ER -