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Congenital malformations of the upper limbs

 
, medical expert
Last reviewed: 23.04.2024
 
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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

trusted-source[1], [2], [3], [4], [5], [6], [7]

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