Advertisement
Research Article| Volume 2, ISSUE 4, P204-224, November 2002

Congenital hand anomalies: Principles of management

      Abstract

      Congenital anomalies of the hand present as challenges to the hand surgeon. To handle these problems well, the surgeon must analyze the complexity of the problem, set the right priorities, choose the right timing for intervention, apply a multitude of techniques, and plan ahead for rehabilitation. Any reconstruction must not do any harm. Reconstructions have their limitations; either too optimistic or too conservative would bring inferior results. The functional consideration is far more important than structural restoration. With the admirable ability of the small children to adapt to structural defects, one expects reasonable functional achievements even with limited structural restorations. The diversity of problems, the complexity of planning, and the demand for surgical skills in the management of congenital anomalies are well illustrated in two examples, Thumb Deficiency and Radial Club Hand. Copyright © 2002 by the American Society for Surgery of the Hand
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      References

        • Entin MA
        Principles of hand function.
        Clin Plast Surg. 1976; 1: 106-128
        • Bora A
        • Ada S
        • Ozerkan F
        Replantation and their functional results: the Turkish experience.
        Microsurgery. 1993; 14: 97-101
        • Duspwa W
        • Bremer E
        • Hanfmann B
        Soll man einen einzelnen langfinger replantierer?.
        Handchir Mikrochir Plast Chir. 1984; 16: 31-33
        • Razana A
        • Hyzan MY
        Hand replantation and revascularization.
        Med J Malaysia. 1998; 53A: 121-130
        • Millesi H
        The current state of peripheral nerve surgery in the upper limb.
        Ann Chir Main. 1984; 3: 18-34
        • Lamb DW
        The treatment of radial club hand.
        Hand. 1972; 4: 22-30
        • Mark G
        • Widder W
        • Trepp A
        Recurrent idiopathic arterio-venous malformation of the back of the hand.
        Handchir Mikrochir Plast Chir. 1991; 23: 46-50
        • Leung PC
        Tuberculosis of the hand.
        Hand. 1978; 10: 285-288
        • Muira T
        Atlas of congenital hand anomalies.
        Kanehara Co. Ltd, Japan1993
        • Benson LS
        • Waters PM
        • Kamil NI
        Camptodactyly classification and results of non-operative treatment.
        J Pediatr Orthop. 1994; 14: 814-819
        • Miura T
        • Nakamura R
        Surgical procedure for the cleft hand.
        Congenital Anomalies. 1984; 24: 439-449
        • Burgess RC
        Brachydactyly type C.
        J Hand Surg [Am]. 2001; 26: 31-39
        • VanBokhoven H
        • Jung M
        • Smits AP
        • et al.
        Limb mammary syndrome.
        Am J Hum Genet. 1999; 64: 538-546
        • Kjaer I
        • Hjalgrim H
        Cranial and hand skeleton in fragile x syndrome.
        Am J Med Genet. 2001; 100: 156-161
        • Borochowitz Z
        • Langer L
        Spondylo-meta-epiphyseal dysplasia, short limb hand type.
        Am J Med Genet. 1993; 45: 320-326
        • Stanton RP
        • Rao N
        Orthopaedic manifestations in de Barsy syndrome.
        J Pediatr Orthop. 1994; 14: 60-62
        • Swanson AB
        • Swanson G
        A classification of congenital limb malformations.
        J Hand Surg. 1983; 8: 693-702
        • Milford L
        The hand. Campbell's Operative Orthopaedics.
        5th ed. CV Mosby, St. Louis1971 (282-285)
        • Tajima T
        Some new techniques in the treatment of congenital anomalies of the hand. In: Current Trends in Hand Surgery.
        Elsevier, Amsterdam1995 (499-511)
        • Tada K
        • Yonenobi K
        Polydactyly-an analysis of 232 cases.
        J Japan Orthop Assoc. 1980; 54: 121-134
        • Cheng JCY
        • Leung PC
        Polydactyly of the thumb.
        J Hand Surg. 1984; 9: 2, 155-164
        • Flatt AE
        The care of congenital hand anomalies.
        CV Mosby, St. Louis1989
        • Barsky AJ
        Congenital anomalies of the hand.
        J Bone Joint Surg Am. 1951; 33A: 35-64
        • Cohen Jr, MM
        • Kreiborg S
        Hands and feet in the Apert syndrome.
        Am J Med Genet. 1995; 57: 82-96
        • Schernberg F
        • Fornage B
        • Collin JP
        Real time ultrasonics: a method of hand imaging.
        Ann Chir Main. 1987; 6: 239-244
        • Al-qattan MM
        Classification of hand anomalies in Poland's syndrome.
        Br J Plast Surg. 2001; 54: 132-136
        • Neumann K
        • Lauger R
        Traumatologie des distalen unterarmes, der handgelenke und der hand.
        Aktuelle Radiol. 1996; 6: 171-175
        • Littler JW
        • Cooley SGE
        Opposition of the thumb and its restoration by adductor digit quinti transfer.
        J Bone Joint Surg Am. 1963; 45A: 1389-1396
        • Barton NJ
        Fracture fixation in the hand.
        J Hand Surg [Br]. 1992; 17B: 289-310
        • Foucher G
        • Medina J
        Toe transfer in congenital hand malformations.
        J Reconstr Microsurg. 2001; 17: 1-7
        • Vilkki SK
        Long term review of radial longitudinal deficiency.
        (Proceedings of the 3rd Congress of Federation of European Societies of Surgeons of Hand, Paris)April, 1996
        • Bunnell S
        The management of the non-functional hand: reconstruction against prosthesis.
        Artif Limbs. 1957; 4: 76
        • Leung PC
        • Chan WT
        A medico-social study on occupational hand injuries in Hong Kong. In: Current concepts in hand surgery.
        Lea & Feabiger, Philadelphia1983 (265-270)
        • Taylor E
        • Humphry R
        Survey of physical agent modality use.
        Am J Occup Ther. 1991; 45: 924-931
        • Morris AF
        • Brown M
        Electronic training devices for hand rehabilitation.
        Am J Occup Ther. 1976; 30: 376-379
        • Bush DC
        • Williams DA
        Hand rehabilitation retrospective.
        Clin Plast Surg. 1986; 13: 293-300
        • Brown DM
        • DeBacher GA
        Feedback goniometers for hand rehabilitation.
        Am J Occup Ther. 1979; 33: 458-463
        • Bentham JS
        • Breretow WD
        • Cochrane W
        Continuous passive motion device for hand rehabilitation.
        Arch Phys Med Rehabil. 1987; 698: 248-250
        • Lamb DW
        Radial club hand.
        J Bone Joint Surg Am. 1977; 59A: 1-13
        • Buck-Gramcko D
        Pollicization.
        in: Congenital malformations of the hand and forearm. Churchill Livingstone, London1998: 379-402
        • Kleinman WB
        • Strickland JW
        Thumb reconstruction.
        in: 4th ed. Green's operative hand surgery. Churchill Livingstone, London1999: 2068-2069
        • Flatt AE
        The care of congenital hand anomalies.
        Quality Medical Publishing, St. Louis1994 (96-119)
        • Clark DI
        • Chell J
        • Davis TR
        Pollicization of the index finger. A 27-year follow up study.
        J Bone Joint Surg Br. 1998; 80B: 631-635
        • Manske PR
        • Rotman MB
        • Dailey LA
        Long-term functional results after pollicization for the congenitally deficient thumb.
        J Hand Surg [Am]. 1992; 17A: 1064-1072
        • Buck-Gramcko D
        Radialization as a new treatment for radial club hand.
        J Hand Surg [Am]. 1985; 10A: 964-968
        • Kay SPJ
        Hypoplastic and absent digits.
        in: 4th ed. Green's operative hand surgery. Churchill Livingstone, New York1999: 368-389
        • Manske PR
        • McCarroll Jr., HR
        Radial club hand.
        in: Congenital malformations of the hand and forearm. Churchill Livingstone, London1998: 433-447
        • Manske PR
        • McCarroll Jr, HR
        • Swanson K
        Centralization of the radial club hand; an ulnar surgical approach.
        J Hand Surg. 1981; 6: 423-433
        • Tsuge K
        • Watari S
        New surgical procedure for correction of club hand.
        J Hand Surg [Br]. 1985; 10B: 90-94
        • Vilkki SK
        Distraction and microvascular epiphysis transfer for radial club hand.
        J Hand Surg [Br]. 1998; 23B: 445-452
        • Hovius SER
        • Luijsterbrug AJM
        Distractions in radial dysplasia at wrist level.
        in: Congenital difference of the upper limb. Yamagata University School of Medicine, Yamagata2000: 229-234
        • Kessler I
        Centralization of the radial club hand by gradual distraction.
        J Hand Surg [Br]. 1989; 14B: 37-42
        • Alatt AE
        The care of congenital hand anomalies.
        Quality Medical Publishing, St. Louis1994 (355-410)
        • Pilz SM
        • Muradin MS
        • Vand er Meulen JJ
        • Hovius SE
        Evaluation of five different incisions for correction of radial dysplasia.
        J Hand Surg [Br]. 1998; 23B: 183-185
        • Wood VE
        Congenital elbow contractures.
        in: Congenital malformations of the hand and forearm. Churchill Livingstone, London1998: 463-486
        • Damore E
        • Kozin SH
        • Thoder JJ
        • Porter S
        The recurrence of deformity after surgical centralization for radial club hand.
        J Hand Surg [Am]. 2000; 25A: 745-751
        • Goldfarb CA
        • Klepps SJ
        • Dailey LA
        • Manske PR
        Functional outcome after centralization for radius dysplasia.
        J Hand Surg [Am]. 2002; 27A: 118-124
        • Kawabata H
        • Shibata T
        • Masatomi T
        • Yasui N
        Radical deformity in congenital radial club hands after previous centralization of the wrist. Ulnar lengthening and correction by the Ilizarov method.
        J Bone Joint Surg Br. 1998; 80: 762-765
        • Pickford MA
        • Scheker LR
        Distraction lengthening of the ulnar in radial club hands using Ilizarov technique.
        J Hand Surg [Br]. 1998; 23B: 186-191
        • Kawabata H
        • Shibata T
        • Matsui Y
        • Yachi K
        • Tanaka H
        Residual deformity correction by the Ilizarov method in congenital club hands after previous centralization of the wrist.
        in: Congenital differences of the upper limb. Yamagata University School of Medicine, Yamagata2000: 235-238