guidebook. - Fanconi Anemia Research Fund

Chapter 5: Hand and Arm Differences in FA
113
Figures 11A and 11B: X-ray and clinical appearance after
centralization with positioning of the carpus onto the distal ulna.
(Courtesy of Shriners Hospital for Children, Philadelphia)
The carpus is then reduced onto the distal ulna for
centralization. In severe cases, adequate reduction cannot
be obtained and alternative measures are necessary.
Surgical options include carpectomy, limited shaving
of the distal ulna epiphysis or application of an external
fixator followed by post-operative distraction and
delayed formal centralization. In fact, many cases of
radial deficiency with rigid deformity are treated with
preliminary soft tissue distraction (i.e., external fixation)
prior to centralization to stretch the tight radial