Classification of 578 cases of congenital upper limb anomalies with the IFSSH system--a 10 years' experience

There were 578 patients with more than 728 congenital anomalies of the upper limb seen in our center over a 10-year period. All anomalies were classified with the system recommended by the International Federation of Societies for Surgery of the Hand (IFSSH). Our results differ from other reported series with group III duplication anomalies being most common (35.9%) followed by group II (31.3%); group I (12.2%); group VII (9.3%), group VI (6.5%), group V (4.3%), and group IV (0.5%). Variations among different ethnic groups are significant although some apparent differences can also result from different patient referral patterns and method of classification. The classification adopted by the IFSSH was found to be practical in the majority of cases. However, difficulties were encountered in the classification of multiple anomalies; group VII cases and the complex spectrum of atypical cleft hand, brachysyndactyly, and transverse arrests. In addition, many common anomalies had not been included in the classification.