Centralisation of the radial club hand by gradual distraction. 
Centralisation of the carpus on top of the distal end of the ulna in radial club hand of types III and IV has been performed by gradual distraction.  For this purpose, I have used the apparatus originally developed for lengthening of digital structures and the forearm.  This technique avoids extensive dissection and acute stretching of the radial neuro-vascular structures.  Experience has shown that gradual distraction is a safe and relatively simple method for correction of the deformity, particularly in long-standing and neglected cases.