# Conservative Approach to Type III Ulnar Club Hand: Case Report

## TL;DR

A 6-year-old boy with severe ulnar club hand improved through conservative physical therapy, showing functional gains without surgery.

## Contribution

Demonstrates successful conservative management of type III ulnar club hand through physical therapy and long-term follow-up.

## Key findings

- Conservative physical therapy improved strength and functional skills in a type III ulnar club hand case.
- Outpatient follow-up until skeletal maturity is essential to monitor for potential surgical needs.
- Patients with severe ulnar dysplasia can achieve daily life functionality through rehabilitation.

## Abstract

Ulnar club hand is a rare condition of the upper limbs, for which treatment depends on the degree of morphological and functional impairment, correlating with the radiographic classification of Dobyns, Wood, and Bayne. The aim of the present study is to report a case of a 6-year-old male patient, followed up for type III ulnar club hand (total ulnar dysplasia). Despite the initial difficulty of manipulating objects and performing everyday tasks, conservative physical therapy treatment provided strength gain and development of functional skills for daily life. We conclude that patients with type III deformity can be properly managed with rehabilitation although they require outpatient follow-up until skeletal maturity is reached, as dynamic deformities and new functional limitations may lead to need for corrective surgeries.

A mão torta ulnar é uma rara afecção de membros superiores, cujo tratamento depende do grau de comprometimento morfológico e funcional, que se correlaciona com a classificação radiográfica de Dobyns, Wood e Bayne. O objetivo deste estudo é relatar um caso de um paciente de 6 anos de idade, do sexo masculino, acompanhado devido a mão torta ulnar do tipo III (aplasia total da ulna). Apesar da dificuldade inicial de manipular objetos e realizar tarefas cotidianas, o tratamento conservador fisioterapêutico propiciou o ganho de força e o desenvolvimento de habilidades funcionais para a vida diária. Concluímos que pacientes com deformidade do tipo III podem ser manejados adequadamente com reabilitação embora necessitem de seguimento ambulatorial até a maturidade esquelética, pois deformidades dinâmicas e novas limitações funcionais podem levar à necessidade de cirurgias corretivas.