الفهرس 
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Abstract
RCH remains a difficult problem resulting in functional limitations, particularly in bilateral cases. The current surgical treatment of this condition is still inadequate in regaining normal appearance and function within the wrist, in addition to the significant affection in ulnar length.More satisfactory results can be obtained by good preoperative preparation by gradual passive stretching, intraoperative caution when dealing with the distal ulnar epiphysis, meticulous dissection of any tight fibrous band, scheuduled postoperatve physiotherapy, familial education and early surgery Results of centralization procedure should provide good correction of the deformity without loss of function of the limb, and so it still can be a standard procedure in tratment of patients with RCH with acceptable results. It is difficult to evaluate functional improvement subsequent to surgical correction of congenital hand deformities in young children as the specific measurements of strength and functional activities are frequently of little value, since these parameters are known to improve as hand grows in size and as the child matures. We also believe that the significance of the centralization procedure is not that it corrects the abnormal HFA, but that it corrects the abnormal position of the hand as the angulation is flexible and can be corrected manually during examination and radiographic imaging.Limitations of the study Like all other studies, this study ahd also limitations. One of the most important limitations of this study was to compare the operated side with the normal side in unilaterally affected cases despite high incidence of bilateral affection.Also, the preoperative and the immediate post operative measurements regarding the HFA, HFP, UL was not available for all cases to study the recurrence of deviation after the follow up period.