Congenital anomalies of the upper extremities

In pediatric orthopedics, congenital anomalies of the upper limbs are a rare pathology, which, however, has a variety of clinical signs.

This is why a single, generally accepted treatment tactic and treatment methods have not yet been developed. Most surgeons suggest that parents wait until the child has finished growing (i.e. until 14-16 years old) and then begin any surgical interventions. As experience shows, beginning treatment at this age is often pointless. All leading surgeons specializing in hand surgery (according to foreign literary sources) believe that upper limb deformities should be eliminated as early as possible, before the child becomes aware of them and develops adaptive stereotypes of function. Therefore, a doctor who has identified a congenital malformation of the upper limbs in a child will greatly appreciate the prompt referral for consultation and diagnosis to a specialized hand surgery center.

I.V. Shvedovchenko (1993) developed a classification of congenital malformations of the upper limbs, and the author systematized and presented in the form of a table all forms of underdevelopment according to teratological series. The basic principles, strategy and tactics of treating congenital malformations of the upper limbs were developed.

Classification of congenital malformations of the upper limbs

Defect variant	Characteristics of the defect	Localization of the defect	Clinical designation of the defect
I. Defects caused by violation of linear and volumetric parameters of the upper limb	A. Towards a decrease	Transverse distal	Brachydactyly Ectrodactyly Adactyly Hypoplasia Aplasia
		Transverse proximal	Proximal ectromelia of the arm
			Splits of the wrist
		Longitudinal distal	Clubhand ulnar and radial
	B. Towards an increase	Longitudinal proximal	Gigantism
II. Defects caused by disturbance of quantitative relationships in the upper limb		Brushes	Polyphalangy Polydactyly Beam doubling
		I finger	Triphalangism
		Forearms	Duplication of the ulna
III. Defects caused by impaired differentiation of soft tissues		Brushes	Syndactyly Tightening in isolated form
		Forearms and shoulders	Tightening in isolated form
IV, Defects caused by impaired differentiation of the musculoskeletal system		Brushes	Brachymetacarpy
		Forearms	Radioulnar synostosis Radial-humeral synostosis Madelung's deformity
V. Defects caused by impaired differentiation of the tendon-muscle apparatus		Brushes	Stenoesing ligamentitis Camptodactyly Flexion-adduction contracture of the first finger Congenital ulnar deviation of the hand
VI. Combined defects	Developmental defects as combinations of the listed pathological conditions		As an isolated manifestation of hand damage As a syndrome complex

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