Radial hemimelia is a congenital abnormality characterized by partial or total absence of the radius bone of the forearm. It falls within the spectrum of radial ray anomalies.
This deformity is believed to develop at around the 28th to 56th day of gestation. The exact etiology has not been proven, however uterine compression, vascular injury, and certain maternal drug consumption have been postulated.
Classification
type I: short distal radius
type II: hypoplastic radius
type III: partial absence of radius
type IV: complete absence of radius 3
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Radiographic features
Antenatal ultrasound
Radial hemimelia can be detected in the anomaly scan done in the second trimester.
Treatment and prognosis
Straightening of the hand and wrist stabilization through splinting are both techniques utilized after birth 4. Physiotherapy is required to improve passive extension of the elbow and wrist. Surgical correction (e.g. osteotomy, arthrodesis, fibular transplants, and centralisation) is used in severe cases, generally performed at age 1 5,6. Pollicisation is used if an absent thumb is present.
1. O'rahilly R. Radial hemimelia and the functional anatomy of the carpus. J. Anat. 2007;80 (Pt 4): 179-83. Free text at pubmed - Pubmed citation
2. Corbera JA, Pulido M, Morales M et-al. Radiological findings in three cases of paraxial radial hemimelia in goats. J. Vet. Med. Sci. 01;64 (64): 843-5. doi:10.1292/jvms.64.843 - Pubmed citation
3. Heikel HV. Aplasia and hypoplasa of the radius: studies on 64 cases and on epiphyseal transplantation in rabbits with the imitated defect. (1959) Acta orthopaedica Scandinavica. Supplementum. 39: 1-155. Pubmed
4. Bora FW, Nicholson JT, Cheema HM. Radial meromelia. The deformity and its treatment. (1970) The Journal of bone and joint surgery. American volume. 52 (5): 966-79. Pubmed
5. Watson HK, Beebe RD, Cruz NI. A centralization procedure for radial clubhand. (1984) The Journal of hand surgery. 9 (4): 541-7. Pubmed
6. Nanchahal J, Tonkin MA. Pre-operative distraction lengthening for radial longitudinal deficiency. (1996) Journal of hand surgery (Edinburgh, Scotland). 21 (1): 103-7. Pubmed