Pre-operative casting by Mehta technique effective way to reduce hand forearm angle in radial hemimelia: Study

Dr Supreeth  D R

Pre-operative casting by Mehta technique effective way to reduce hand forearm angle in radial hemimelia: Study

Written By : Dr Supreeth D R Published On 2025-12-19T20:00:43+05:30 | Updated On 19 Dec 2025 8:01 PM IST

Radial hemimelia is a complex deformity with varying severity. Soft tissue stretching with plaster casts is recommended before definitive surgery of the wrist. There is no clear description of the casting method in literature. Applying plasters is challenging due to small working length of the forearm and absence of the thumb in most cases, leading to cast slippage.

The original study by Rujuta Mehta et al describes Mehta technique of casting and stepwise reduction manoeuvres based on pathomechanics of the dysplastic wrist as a novel method.

The authors studied the effects of this novel technique on 30 patients with a total of 43 hands. Different parameters such as wrist flexion deformity, clinical and radiological hand forearm angle were compared pre- and post-casting treatment.

The key findings of the study were:

• The study contained a total of 30 patients, 21 male and 9 female, with a total of 43 hands (right 24, left 19), with a mean age of presentation being 16.5 months during the first cast.

• The earliest presenting age was 12 days and the latest being a 4 year 7-month-old child.

• Minimum follow up was of 1 year and maximum of 7 years with a mean follow-up duration of 2.7 years.

• Successful reduction of ulno-carpal override and significant improvement in hand forearm angle was achieved.

• The hand forearm angle improved from 51.62° to 11.34° after completion of serial casting with a P value of less than 0.001, which was statistically significant.

The authors concluded – “Pre-operative casting by Mehta technique is an effective way to reduce the hand forearm angle in radial hemimelia. It is a baby-friendly, easy, cost effective, outpatient-based treatment, not age dependent, valuable for syndromic children and more convenient to perform than the conventional fixator assisted distraction. The casting technique can be used as a routine procedure, prior to the final surgery to centralise/radialize the carpal complex over the ulna, thereby reducing the need for extensive soft tissue procedures intraoperatively.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.