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Related Experiment Video

Updated: Feb 12, 2026

Functional MRI in Conjunction with a Novel MRI-compatible Hand-induced Robotic Device to Evaluate Rehabilitation of Individuals Recovering from Hand Grip Deficits
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A comprehensive functional classification of cleft hand: The DAST concept.

Alok Sharma1, Namita Sharma2

  • 1Professor and Consultant Plastic Surgeon, Commandant Military Hospital, Jabalpur, Madhya Pradesh, India.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India
|April 6, 2018
PubMed
Summary

A new classification system, DAST (Digits missing, Associated anomalies, Site, Thumb function), aids in managing congenital cleft hand deformities. This system quantifies complexity to standardize surgical choices and predict outcomes.

Keywords:
Classificationcleft handdiagnosissurgical management

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Area of Science:

  • Hand surgery
  • Congenital deformities
  • Orthopedic classification

Background:

  • Congenital cleft hand exhibits variable presentations, complicating surgical decision-making.
  • Existing classification systems often fail to capture all relevant aspects of the deformity.
  • Morphological parameters are crucial for assessing hand function and surgical restoration potential.

Purpose of the Study:

  • To introduce a comprehensive and universally accepted classification for congenital cleft hand deformities.
  • To graphically represent the full spectrum of presentations, including principal and associated anomalies.
  • To standardize surgical procedure selection and intervention timing for optimal patient outcomes.

Main Methods:

  • The study analyzed a cohort of 27 patients with 38 affected hands.
  • A novel classification system, DAST (Digits missing, Associated anomalies, Site, Thumb function), was developed.
  • Numerical values were assigned to each component to quantify complexity.

Main Results:

  • The DAST classification system was established, incorporating key morphological determinants.
  • Each component and the aggregate DAST score provide a graphical representation of complexity.
  • The system demonstrated a predictive value for surgical procedure selection and outcome prognosis.

Conclusions:

  • The DAST classification addresses the need to assess all functional and complexity determinants in cleft hands.
  • It standardizes management by providing a clear framework for surgical intervention.
  • The DAST system offers a valuable tool for predicting surgical success in congenital cleft hand cases.