Ulnar Deficiency Ulnar Clubhand

Scott H. Kozin

History and Clinical Presentation

A 5-month-old boy presented with congenital anomalies of both upper extremities (Fig. 77—1). He is the product of a full-term pregnancy, born by cesarean section delivery. There were no complications during pregnancy or delivery. The child is otherwise healthy and has attained his early developmental milestones at the appropriate time. There is no family history of congenital anomalies, including two siblings without abnormalities.

Physical Examination

The patient is a healthy-appearing infant with congenital anomalies of both upper extremities. His right extremity is longer than his left. Both shoulders had full range of motion and strength. Both elbows and forearms had no active or passive motion. The right elbow was fixed at 45 degrees of flexion and the forearm rigid in neutral rotation. The left elbow appeared to be hyperextended with the forearm facing backward and

Hand Anomalies
Figure 77—1. (A) A 5-month-old child with congenital anomalies of both upper extremities. The right elbow is fused in slight flexion and the left elbow is fused facing backward. (B) Hand anomalies with bilateral three-digit hands.

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