Congenital malformations of the upper limbs

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

That is why a single common tactic of treatment, as well as methods of treatment, have not yet been developed. Most surgeons offer parents to wait until after the child's growth (ie, up to 14-16 years), and then start any surgical intervention. Experience shows that it is often pointless to start treatment at this age. All the leading surgeons. (according to foreign literature sources) believe that the deformities of the upper limbs must be eliminated as early as possible, to the awareness of their child and the development of adaptive function stereotypes. Therefore, the great merit of the doctor, who determined the child's congenital malformation of the upper limbs, will soon be directed to consultation and diagnosis in a specialized center for hand surgery.

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

Classification of congenital malformations of the upper limbs

Variant of defect	Defect characteristic	Defect localization	Clinical designation of a defect
I. Defects caused by violation of linear and volumetric parameters of the upper limb	A. In the direction of decreasing	Transverse distal	Brahidactyly Ectrodactyly Adactyly Hypoplasia Aplasia
		Transverse proximal	Proximal ectromelia of the shoulder
			Cleavage Brushes
		Longitudinal distal	Helm and elbow
	B. Increase	Longitudinal proximal	Gigantism
II. Defects caused by a violation of quantitative relationships on the upper limb		Brushes	Polifalangia Polydactyly Doubling the Beam
		I finger	Three-phalanx
		Forearms	Doubling of the ulna
III. Defects due to impaired soft tissue differentiation		Brushes	Syndactyly Binds in isolation
		Forearms and Shoulders	Binds in isolation
IV, Defects due to impaired differentiation of the osteoarticular apparatus		Brushes	Brachymetacarp
		Forearms	Radiostar synostosis Pleural sinostosis Deformation of Madelung
V. Defects caused by a violation of differentiation of the tendon-muscle apparatus		Brushes	Stenoating ligamentitis Camptodactyly Flexing-leading contracture of the 1st finger Congenital ulnar deviation of the hand
VI. Combined defects	Developmental flaws as a combination of these pathological conditions		As an isolated manifestation of a lesion of the wrist As a syndrome

[1], [2], [3], [4], [5], [6], [7]