The timing of surgery for radial dysplasia depends upon the severity of the clinical features.
Within the first nine months, for type I and II hypoplasia, there may be a need to lengthen the radius. Types III and IV may benefit from centralization or radialization of the wrist with or without prior distraction. Ideally, this is undertaken as early as possible and certainly within the first year of life.
By two years of age, if there is severe thumb hypoplasia, pollicization may be necessary.
After two years, a number of adjunctive procedures can be employed. These include distraction lengthening of the ulna, ulna osteotomies to correct bowing and opponensplasty.
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