Conservative Approach to Type III Ulnar Club Hand: Case Report

Cury, Gabriel Chartuni Teixeira; Sá, Leonardo Álaf Lucinda de; Oliveira, Cler David; Caires, Nathália Vieira; Jesus Filho, Arnaldo Gonçalves de; Souza, Bruno Gonçalves Schroder e

doi:10.1055/s-0041-1735137

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Revista Brasileira de Ortopedia

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Case Report • Rev Bras Ortop 59 (suppl 1) • 2024 • https://doi.org/10.1055/s-0041-1735137 copy

Conservative Approach to Type III Ulnar Club Hand: Case Report

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Ulnar club hand is a rare condition of the upper limbs, for which treatment depends on the degree of morphological and functional impairment, correlating with the radiographic classification of Dobyns, Wood, and Bayne. The aim of the present study is to report a case of a 6-year-old male patient, followed up for type III ulnar club hand (total ulnar dysplasia). Despite the initial difficulty of manipulating objects and performing everyday tasks, conservative physical therapy treatment provided strength gain and development of functional skills for daily life. We conclude that patients with type III deformity can be properly managed with rehabilitation although they require outpatient follow-up until skeletal maturity is reached, as dynamic deformities and new functional limitations may lead to need for corrective surgeries.

Keywords
hand deformities, congenital; musculoskeletal abnormalities; phocomelia; ulna/abnormalities; upper extremity deformities, congenital

	Before physical therapy	After physical therapy
Function	Limitation of the use of individual phalanx in the right hand Palmar grip limitation for performing functional tasks Scapular dyskinesia during abduction to pick up object on shelf	Acquisition of the ability to use individual phalanx (muscle strength: grade 4/5) Palmar grip enhancement No improvement observed
Strength	Right upper limb hypotonia Patient could move through full range of motion against gravity Patient could not carry weighted object/toy with right upper limb	Maintained Maintained Maintained
Specific tasks	Patient could feed himself Patient could use cell phone Patient could not get dressed independently Patient could not put his shoes on Patient could not open locks Patient could not open bottles Patient could not open packet of cookies	Maintained Improved with use of individual phalanx Partial function acquisition^* * Partial acquisition of function: Gain of function with difficulty and/or limitation in the execution of the movement. Partial function acquisition Function acquisition^ Function acquisition: Function gain with adequate adaptation to movement execution. Function acquisition Function acquisition

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E-mail: rbo@sbot.org.br

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[1] Address for correspondence Gabriel Chartuni Teixeira Cury, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora/ Brazil, Rua Maria José Leal, 98, Granville, Juiz de Fora, Minas Gerais, Brazil (e-mail: gabrieljocury@gmail.com).