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Analysis of anatomic variations in cleft hands.
1Department of Orthopaedic Surgery, Schleswig-Holstein University Hospital, Kiel, Germany.
The Journal of Hand Surgery
|December 4, 2004
Summary
This study analyzed 54 cleft hands, revealing distinct X-ray patterns like aplasia and synostosis. Findings varied by cleft location and classification, aiding in understanding these congenital hand differences.
Area of Science:
- Orthopedics and Hand Surgery
- Congenital Malformations
- Radiology
Background:
- Cleft hand is a congenital upper limb malformation with diverse clinical presentations.
- Understanding the radiographic patterns is crucial for accurate diagnosis and classification.
Purpose of the Study:
- To analyze clinical and X-ray findings in 54 cleft hands from 31 patients.
- To detail malformation-associated X-ray patterns, specifically aplasia and synostosis.
- To correlate findings with cleft location and the Manske and Halikis classification system.
Main Methods:
- Retrospective review of clinical data and radiographs from 31 patients with 54 cleft hands.
- Comparison of findings with existing literature.
- Classification of cleft hands by location and the Manske and Halikis system, arranging deformities in teratologic sequences.
Main Results:
- Syndactyly was observed in 30 hands, most commonly between the ring and small fingers; polydactyly occurred in 3 hands.
- Aplasia and synostosis were the predominant X-ray patterns.
- Radial cleft hands were more frequently bilateral and associated with cleft feet; aplasias were common in radial clefts, while synostoses were more frequent in central clefts.
- Manske and Halikis classification showed correlations: unilateral cleft hands often Type I, bilateral with cleft feet Type IV/V. Synostoses were associated with Types I-III, and aplasias with Type V.
Conclusions:
- Distinct differences exist between radial and central cleft hands based on clinical and radiographic analysis.
- The Manske and Halikis classification system effectively categorizes cleft hand deformities, correlating with specific X-ray patterns and locations.