Radial Clubhand is a rare birth defect characterized by a deformity of the hand, with a perpendicular relationship between the forearm and wrist, and an absent thumb.

Can be due to either radial ray (Pre axial) deficiency ( more common) or Ulnar ray (postaxial) deficiency.

Either radius or ulna can be hypoplastic or partially or completely absent.

Mostly sporadic in occurance.

Syndromic association are common with radial club hand. ( Holt Oram Syndrome, Fanconi`s anemia, TAR, etc.)

Variable degrees of thumb deficiencies are frequent with all patterns.

Various musculoskeletal deficiencies are also there including the absence of brachialis, brachioradialis, and thenar muscles.

A complete workup is necessary for patients with radial clubhand to rule out other associated malformations.

Management depends upon the type of radial deficiency and age at presentation.

Immediately after birth: passive manipulation, casting followed by splinting. But correction is usually lost with time due to soft tissue imbalance.

Patient usually requires surgical intervention

1. Centralization of the wrist over the ulna.
2. Thumb reconstruction ( Policisation ).
3. Triceps transfer to restore elbow flexion contracture.