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Synpolydactyly of the hand: a radiographic classification
L B Wall1, D S Bae2, S N Oishi3
1Department of Orthopaedic Surgery, Shriner's Hospital for Children and St. Louis Children's Hospital at Washington University School of Medicine, St Louis, MO, USA.
The Journal of Hand Surgery, European Volume
|August 14, 2015
Summary
This study introduces a reliable radiographic classification for synpolydactyly, a rare congenital hand anomaly. The system aids clinicians in diagnosing and communicating about this condition.
Area of Science:
- Orthopedics
- Congenital Anomalies
- Radiology
Background:
- Synpolydactyly is a rare congenital anomaly involving polydactyly and syndactyly in the central hand.
- Accurate classification is crucial for understanding and managing this condition.
Purpose of the Study:
- To develop a reliable radiographic classification system for synpolydactyly.
- To assess the inter-rater and intra-rater reliability of this new system.
Main Methods:
- A radiographic classification system was developed based on location, bony level, and delta phalanx presence.
- Fifty-six hands with central synpolydactyly were analyzed.
- Four pediatric hand surgeons independently reviewed radiographs to establish reliability.
Main Results:
- The classification system demonstrated high reliability, with 71% exact agreement among raters.
- Inter-rater reliability was 0.97, and intra-rater reliability was at least 0.87.
- Common presentations included types 1A and 2A, with symmetric classification in 7 of 16 bilateral cases.
Conclusions:
- A new, reliable radiographic classification system for synpolydactyly has been established.
- This system is expected to improve clinical communication and provide a basis for future research.
- The classification categorizes synpolydactyly based on key radiographic features.
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