Children's Hospital Colorado

Radial Dysplasia (Radial Longitudinal Deficiency/Radial Club Hand)

What is radial dysplasia?

Radial dysplasia – also known as radial longitudinal deficiency or radial club hand – is a condition in which:

  • The radius does not form normally, and the radius bone might be short or missing completely.
  • The thumb might be small and does not work normally or the thumb might be missing completely, known as thumb hypoplasia/aplasia.
  • Some of the bones and other structures of the forearm, wrist or hand might not be normal or are missing completely.
  • There is often a curving of the forearm toward the thumb.

About hand, wrist and forearm bones

The forearm (area between the wrist and the elbow) has two bones:

  • Radius: bone on the thumb side of the arm
  • Ulna: bone on the small finger side of the arm

The hand and wrist have many bones, including:

  • Phalanges (finger and thumb bones)
    • Each finger has three bones.
    • Each thumb has two bones.
  • Metacarpals (main bones in the palm of the hand)
  • Carpals (wrist bones)

What causes radial dysplasia?

Radial dysplasia occurs when bones of the arm do not grow normally when the baby is growing in the mother's uterus.

The cause of this is unknown. It is often part of a syndrome (a group of symptoms) and/or might be a genetic condition (passed down in families).

How is radial dysplasia diagnosed?

  • Radial dysplasia can sometimes be seen during an ultrasound when the baby is in the pregnant mother's uterus. It is usually diagnosed by a physical examination.
  • Your child's doctor will often order X-rays to look at the bones of the arm.
  • He or she will also most likely order other tests to see if this is part of a syndrome (a group of symptoms) and might suggest an appointment with our genetics team for further testing and counseling.

How is radial dysplasia treated?

Treatment for radial dysplasia depends on the severity of the condition and often includes occupational or physical therapy. Therapy may include stretching, play and activities, splinting or even casting.

Surgery for radial dysplasia

Treatment depends on the child's overall health and whether surgery can improve the position, movement and function in the arm, wrist and hand.

  • Wrist centralization is a surgery done to put the wrist in the normal position.
  • For children born with a small thumb or a thumb that is missing, see thumb hypoplasia/aplasia.
  • Surgery may involve bones, tendons, ligaments, muscles, joints and/or nerves.
  • Cuts are made in the area to do the surgery and are closed with stitches.
  • If your child is sick any time during the week before surgery, it is important to call the Hand and Upper Extremity Program to find out if the surgery should be rescheduled. The hand nurse is available Monday through Friday for any questions you might have before the surgery.

What to expect after surgery:

  • Your child will be monitored in the Post-Anesthesia Recovery Unit (PACU) for 1-2 hours. As soon as your child is awake, the PACU nurse will let you join him/her.
  • After surgery, your child's arm will have bandages and, most likely, there will be a cast placed over the bandages.

Why choose Children's Colorado for your child's radial dysplasia?

Our Hand and Upper Extremity Program at Children's Colorado provides a comprehensive, multidisciplinary approach to the care of your child. This means you have access to leading specialists from multiple departments who work together to treat your child.