Radialization was first described by Buck-Gramcko(1). There is overcorrection of the axis of the forearm-wrist-hand beyond the midline towards the radial side. This may result in better long-term motion given that there is less shortening and a greater distance for tendon transfers to exert their effect compared to a centralization procedure - a better mechanical advantage.
There is no shortening of the ulna or removal of carpal bones. Radial-sided tendons may be transferred to the ulnar side of the wrist to limit the radial deforming force; typically the fused flexor carpi radialis, extensor carpi radialis longus, extensor carpi radialis brevis and brachioradialis are transferred to the extensor carpi ulnaris tendon. The translocated ulna is held in place with a temporary k wire.
With less bone resection compared to centralization, there may be better longterm growth. However, to achieve full radialization there needs to be a complete passive correction of the radial soft tissue deficiency prior to surgery; this is achieved increasingly with distraction frames.
(1) Buck-Gramcko D (1985). J Hand Surg 1: 964-968.
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