CLUBHANDS

Clubhands are classified into two main groups:

RADIAL CLUBHAND

• Radial clubhand.
• This encompasses a wide spectrum of disorders that include absent thumb, thumb hypoplasia, thin first metacarpal, and absent radius.
• Usually sporadic but may be part of a syndrome.
• Associated with congenital scoliosis.
• Differential diagnosis includes VATER association, Klippel-Feil syndrome and some cases of Goldenhar syndrome.

Associated Syndromes
1. Fanconi's pancytopenia. 2. Aase syndrome. 3. Trisomy 18. 4. Trisomy 21. 5. Deletion of long arm of chromosome 13. 6. Ring formation of chromosome 4. 7. Holt-Oram syndrome. 8. TAR syndrome.
Trisomy 18
Radial club hand Absent radius Absent thumb

ULNAR CLUB HAND

• Ulnar clubhand.
• Less frequent than radial clubhand and encompasses mild deviation of the hand on the ulnar side of the forearm to complete absence of the ulna.
• Usually isolated and not part of a syndrome.
• Syndromes that may be associated include Poland syndrome.

REFERENCES

1. Swanson AB, Tada K, Yonenubo K. Ulnar ray deficiency: It's various manifestations. J Hand Surg 1984;9A:658-664.