Treatment of central longitudinal deficiencies is well defined, with different techniques established for the classical clefts. However, none of these techniques is easily applied to the treatment of very deep clefts accompanied by a significant divergence of the metacarpal bones. In such cases, the results of current techniques are disappointing. We propose a new technique of "Translocation in the Radial direction of the Ulnar Finger(s)" (TRUF) by intra-carpal osteotomy. The results are illustrated in three clinical cases. The TRUF operation allowed closing of the cleft, alignment of the metacarpal bones and preservation of carpometacarpal mobility. When necessary, a metacarpal synostosis may be treated at the same procedure.

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Journal of Hand Surgery
Department of Plastic and Reconstructive Surgery

Foucher, G, Loréa, P, Hovius, S.E.R, Pivato, G, & Medina, J. (2006). Radial shift of the ulnar fingers: A new technique for special cases of longitudinal central deficiency. Journal of Hand Surgery, 31(2), 156–161. doi:10.1016/j.jhsb.2005.12.003