Congenital hand differences: embryology and classification
Related Experiment Video
Updated: Jun 23, 2026

Block Building Task Identifies Distinct Groups of Left/Right-hand Choice Patterns After Unilateral Peripheral Nerve Injury
Published on: March 21, 2025
Douglas M Sammer1, Kevin C Chung
1Department of Surgery, Washington University, St. Louis, MO 63110, USA.
Abstract:
Congenital hand differences affect approximately 1 in 500 persons and present unique diagnostic and classification challenges. The embryology of the hand and upper extremity is discussed, including the molecular basis for patterning of the upper limb. The Swanson/International Federation of Societies for Surgery of the Hand classification system is described, along with a discussion of the difficulties in classifying congenital hand differences based on morphology or etiology.
Related Concept Videos
Changes in the Appendicular Skeleton with Age
Initially, the limb buds consist of a core of mesenchyme covered by a layer of ectoderm. The ectoderm at the end of the limb bud thickens to form a narrow crest called the apical ectodermal ridge. This ridge stimulates the underlying...
Development of the Limb Synovial Joints
The mesenchymal stem cells differentiate into chondrocytes that form the hyaline cartilage, and later the cartilaginous model of the bone. This model further transforms into a bone. This process is known as endochondral ossification.
During development, the limbs...
Classification of Bones
Long and Short Bones
The appendicular skeleton, particularly the upper and lower limbs, is primarily made of long and short bones. The long...
Development of the Sexual Organs in the Embryo and Fetus
Near the gonadal ridges, two duct systems are present: the mesonephric ducts (Wolffian ducts) and paramesonephric ducts (Müllerian ducts). These ducts form the basis for the male...
Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An immobile...
Bones of the Upper Limb: Humerus
