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Congenital malformations of the upper limbs
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 |
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