ABSTRACT
The infant is born with the wrist in marked radial deviation, hence the common name radial club hand; one-half of the patients are affected bilaterally. Surgical correction of a radially deviated wrist in cases where the elbow is stiff can be disastrous. Embryonic abnormalities of the upper limb are likely to affect more than one segment of the limb; therefore, congenital anomalies often appear together in the forearm, wrist and hand. Tuberculous arthritis sometimes occurs at the wrist. Bilateral arthritis of the wrist is nearly always rheumatoid in origin; when only one wrist is affected, the signs resemble those of tuberculosis. Persistent synovitis may call for synovectomy and soft-tissue stabilization of the wrist. Acute ‘wrist sprains' should be carefully assessed for signs of carpal displacement and instability.
