Figure 4. A: clinical picture of a child with TAR syndrome and radial club hand b: AP Radiograph showing “carpal height , as measured between the transverse axis of the metacarpal bases and transverse axis of the ulna. Its an important baseline assessment before starting distraction, for early detection of carpal distraction. c: Measurement of lateral axis deviation between the distal end ulna long axis and 3rd MC long axis, to judge the degree of correction required intra operatively