[Classification of congenital hand anomalies]

Increasing knowledge of the molecular basis of embryonic development has improved our understanding of congenital limb malformations. The most popular current surgical classification of congenital limb anomalies is the Swanson/IFSSH classification. This is based on morphology (appearance). Such a classification is unable to indicate the site in the molecular pathway and/or the anatomical site in the limb bud, nor the time at which the insult occurs. Attempts to alter a classification based on morphology according to increased knowledge of the molecular basis of limb development are flawed. Perhaps it is better to simply describe and document the malformations appearing in any particular limb until such time as a valid classification relating to causation and aetiology at a molecular level can be established.