Purpose
A deeper investigation of medical and musculoskeletal conditions in patients with
ulnar longitudinal deficiency (ULD) is needed. The association between the severity
of the manifestations of ULD in the hands and forearms has not been firmly established.
The purpose of this study was to describe the medical and musculoskeletal conditions
associated with ULD and examine the relationship between hand and forearm anomalies.
Methods
The Congenital Upper Limb Differences registry was queried for all patients with a
diagnosis of ULD, as defined by the Oberg-Manske-Tonkin classification system, between
2014 and 2020. The patients’ demographic information, medical and musculoskeletal
comorbidities, radiographs, and clinical images were reviewed. The participants were
classified using the Bayne, Cole and Manske, and Ogino classification systems.
Results
Of 2,821 patients from the Congenital Upper Limb Differences registry, 75 patients
(2.7%) with ULD (14 bilateral), with 89 affected extremities, were included. Hand
anomalies were present in 93% of the patients. Approximately 19% of the patients had
an associated medical comorbidity, and 20% of the patients had an associated musculoskeletal
condition. Cardiac anomalies were present in 8.0% of the patients, and 12% of the
patients had a lower extremity abnormality. Radial head dislocation was observed in
13 of 18 patients with Bayne type II or III ULD compared with 8 of 43 patients with
other types of unilateral ULD. There was a significant positive association among
the Bayne and Ogino, Bayne and Cole/Manske, and Ogino and Cole/Manske classification
systems in patients with unilateral ULD.
Conclusions
Associated medical and musculoskeletal conditions are common in patients with ULD,
of which cardiac and lower extremity abnormalities are most frequently observed. There
is a significant positive association between the severity of forearm anomalies and
that of hand anomalies in patients with unilateral ULD. All patients with ULD should
undergo a thorough cardiac evaluation by their pediatrician or a pediatric cardiologist.
Type of study/level of evidence
Symptom prevalence study III.
Key words
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Article info
Publication history
Published online: August 02, 2022
Accepted:
May 25,
2022
Received:
January 3,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
