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  Indian J Med Microbiol
 

Figure 3: Ulnarization (generation 3): The capsular release is already done according to the ulnarization procedure for treatment of radial club hand deformity of a case of radial aplasia. The scaphoid if present is released and flapped radially to make room for the ulnar head. The hand is shortened due to contracture relative to the length of the ulna (top left). The ulna is osteotomized proximally and telescoped in a shortening direction to overlap the bone ends (top middle). The hand is straightened out of its radial deviation and the carpus is ulnarized by placing the lunate next to the ulnar head and pinning it to the hand. This causes the ulna to telescope further proximal to the necessary level for reduction (top right). An ulnar osteotomy is done with a saw at the level of overlap of the bone ends (red dashed lines) (bottom left). The bone segment created is removed and the overlapped bone ends of ulna reduced and pinned in the shortened position (bottom middle). The ulnar osteotomy is stabilized by plating and rotational stability of the wrist is achieved by adding two more cross wires (bottom right)

Figure 3: Ulnarization (generation 3): The capsular release is already done according to the ulnarization procedure for treatment of radial club hand deformity of a case of radial aplasia. The scaphoid if present is released and flapped radially to make room for the ulnar head. The hand is shortened due to contracture relative to the length of the ulna (top left). The ulna is osteotomized proximally and telescoped in a shortening direction to overlap the bone ends (top middle). The hand is straightened out of its radial deviation and the carpus is ulnarized by placing the lunate next to the ulnar head and pinning it to the hand. This causes the ulna to telescope further proximal to the necessary level for reduction (top right). An ulnar osteotomy is done with a saw at the level of overlap of the bone ends (red dashed lines) (bottom left). The bone segment created is removed and the overlapped bone ends of ulna reduced and pinned in the shortened position (bottom middle). The ulnar osteotomy is stabilized by plating and rotational stability of the wrist is achieved by adding two more cross wires (bottom right)