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A child is seen in the pediatric orthopedic hand clinic for evaluation of a congenital deformity. A clinical photograph and radiograph are seen in Figures A and B. What is the next best step in this child's evaluation to rule out an associated autosomal-recessive lethal condition?
Cardiac ultrasound and renal ultrasound
Cardiac ultrasound, barium swallow and MRI
LFTs, CBC and cardiac ultrasound
Cardiac ultrasound, peripheral blood smear and MRI
CBC, peripheral blood smear and chromosomal breakage analysis
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A 7-month-old boy has radial longitudinal deficiency. The initial work-up is negative for any cardiac, hematopoetic or renal abnormalities. He has good active elbow flexion and no other deformities. A clinical image and radiograph are seen in Figures A and B. Surgical management should include which of the following?
Definitive splinting and stretching
Pollicization of the index finger
ECRB and ECRL transfers to the ulna
Free fibula transfer to the forearm
Ulna centralization and possible tendon transfers
A 6-year-old boy presents to your office with a forearm deformity and the radiographs shown in Figure A. What additional tests must be ordered for this patient?
CBC and renal ultrasound only
CBC, renal ultrasound, and echocardiogram
CBC and MRI
No additional testing needed
A 2-year-old boy has the upper limb deformity seen in Figures A and B. All of the following are associated with this condition EXCEPT?
A 4-year-old child was born with bilateral congenital radial clubhands. Which of the following associated conditions is a contraindication to centralization of the hands on the ulna?
Lack of elbow flexion
Your partner, a pediatric hand surgeon, sees a child with a congenital upper extremity deformity. A radiograph is shown in Figure A. What is a relative contraindication to performing a hand centralization procedure in this patient?
Diminished grip strength
Limited terminal elbow extension
Current patient age