Congenital malformation of the hand
Release time : 03/20/2025 09:30:02
It's often said that peace is a blessing, health is wealth, but not everyone can fully possess these blessings.
Some people are different from others since they were born.
Congenital deformities are a relatively common condition. So, what exactly is congenital deformity of the hand? What types of congenital hand deformities are there? What causes congenital deformities of the hand? And how is congenital deformity of the hand treated? Below, Mom's Net will provide you with detailed answers. **What is congenital deformity of the hand?** Congenital deformities refer to abnormalities present at birth or pre-birth, or potential abnormal factors.
Humans can have variations in anatomical structure, but this does not usually result in adverse consequences.
Should such an abnormality affect morphology and function to a certain extent, it can also be classified as congenital malformation.
So what is the condition of congenital deformity in hands? Congenital hand deformities are a common group of diseases, with an incidence rate of about 1‰ for newborns. Translation: So what is the condition of congenital deformity in hands? Congenital hand deformities are a common group of diseases, with an incidence rate of about 1 in 1,000 newborns.
Hand and upper limb deformities may occur as isolated conditions, or may coexist with various upper limb deformities. They may also be part of the manifestations of multiple syndromes.
According to statistics, approximately 5% of congenital upper limb deformities are part of syndromes.
Hand and upper limb deformities can also be accompanied by cardiovascular anomalies, hematopoietic system diseases, gastrointestinal anomalies, facial deformities, cranial neurocraniofacial anomalies, urinary and reproductive tract anomalies, and lower limb deformities.
The incidence of deformities of the hands and upper limbs is 0.85‰.
Due to the incompleteness of newborn birth records in hospitals, the actual incidence rate is even higher.
If according to the total number of 1.4 billion people in our country, the number of hand congenital anomalies is about 100 thousand, this is a very important number.
There are a variety of congenital hand deformities. Classification of these is an extremely complex task.
The currently accepted classification system is the one revised by Swanson (1983) and the American Society of Hand Surgery (ASHS) and International Federation of Societies for Surgery of the Hand (IFSSH), which is based on embryology and anatomy. It is more systematic and comprehensive, but it still does not include all types of deformities.
Common simple deformities are named according to the characteristics of the deformity, such as polydactyly (multiple fingers), syndactyly (joint between two or more fingers that cannot be separated), and megadactyly (excessive growth and enlargement of the fingers).
I. Physical Formation Disorders Congenital physical formation disorders, including complete or partial formation disorders, are divided into two types: transverse and longitudinal.
1. Horizontal hand defect: ① Congenital absence of the upper limb.
2. Congenital absence of the wrist.
3. Congenital absence of the radius.
4. Congenital agenesis of the hand.
5. Congenital absence of fingers, the plane of the absent finger can also be located at the level of proximal, middle, or distal phalanges.
2. Longitudinal hand deficiency: ① Radial longitudinal deficiency (radial clubhand).
2. The ulnar side of the hand is missing (ulnar-sided hammer hand).
Central longitudinal deficiency (split hand).
Central longitudinal growth arrest (mid-segment longitudinal deficiency).
Here is the English translation of the provided text: "II. Limb Differentiation Disorders This type of malformation is caused by separation disorders of the fingers. At the wrist joint, it is common to see fusion between carpal bones or fusion between carpal bones and metacarpal bones."
The interphalangeal joints of the digit are commonly fused, with the most common deformity being syndactyly.
1. Soft tissue involvement: Multiple joint flexion, hyperextension of the long extensor muscle, hyperextension of the long flexor muscle, internal deformity of the hand muscles, skin-bound fingers, congenital flexion deformity of the thumb, palmar thumb deformity, non-boney deviation of the thumb, congenital trigger finger/thumb, axillary webbing or elbow webbing deformity, clubbing nails, long nail deformity.
2. Bone involvement.
3. Congenital Tumors and Deformity.
3. Duplication (Twin) Deformities of the Hand: The occurrence of duplicated deformities in the hand may be due to special damage during early formation of the limb buds and external layer capsule which causes partial division of the original embryonic part.
The patient exhibited malformations including polydactyly, arcade of D'Aubigné, and mirror hand.
1. Duplication of all limbs, humerus, radius, and ulna.
2. Twin Hand (Mirror Hand).
3. Polydactyly: ① Radial polydactyly (thumb duplication).
Claw polydactyly (small finger polydactyly).
Central dominance.
Compoundness (the presence of both or both).
4. Excess cartilaginous epiphysis (overgrowth): ① Longitudinal thumb. Please translate the above text into English: 4. Excess cartilaginous epiphysis (overgrowth): ① Longitudinal thumb.
② Show the index fingers in a line.
③ Other.
Note: The above professional knowledge and theory are derived from "Practical Orthopedics".
The etiology of congenital limb deformities is very complex and currently considered to be two types: one is the internal factor, namely genetic factors, which are caused by chromosome abnormalities or gene mutations.
Another factor is the external factor, that is, environmental factors. Factors such as organism, nutrition, drugs, radiation, endocrine and trauma during embryonic period can cause malformation.
Many malformations are the results of a combination of two factors, and the influence of environmental factors may be greater.
I. Genetic factors include: ① Chromosomal abnormalities, encompassing both numerical and structural chromosomal abnormalities.
Due to the majority of cases resulting in miscarriage or stillbirth due to chromosomal abnormalities, clinical cases are not very common.
Gene mutations are the cause of 10%-15% of congenital malformations, but most gene mutations are not associated with congenital malformations.
II. Environmental factors refer to congenital malformations that occur as a result of external environmental influences during the embryonic stage.
1. Bio-factor: Mothers who contract certain diseases during the first three months of pregnancy may cause fetal malformations.
2. Nutritive Factors: Generally, the human mother is unlikely to suffer from deficiencies in nutrition; however, maternal diabetes and certain placental pathologies may affect fetal nutritional supply and embryonic development.
3. Drug factors: Many drugs have teratogenic effects, such as thalidomide and other many sedatives, most anticancer drugs, oral contraceptives, etc.
4. Radiation factors: Ionizing radiation is a potent teratogenic factor, capable of causing genetic mutations and passing them on to the next generation or even the third.
Pregnant and postnatal mice were exposed to X-rays, which showed that there was significant developmental inhibition of fetuses, especially the eyes and brain. There were also malformations such as foot deformities, clefts, absence of limbs, and polydactyly.
5. Endocrine factors: A small amount of insulin injected into the eggshell while it is incubated can cause various malformations in chicks.
6. Trauma: Some believe that hematomas on the embryonic surface can inhibit the development of certain parts of the embryo, resulting in malformations during early embryogenesis.
7. Chemical Factors: Jones (1973) described a syndrome characterized by abnormalities in the cranium, face, limbs, heart, and external genitalia of infants born to alcoholic mothers with global developmental retardation, mental dullness. The syndrome was named fetal alcohol syndrome. Subsequently, hundreds of similar reports have been published, so moderate drinking by pregnant women has been warned to be hazardous.
8. Other factors, in animal experiments, both hyperthermia and hypothermia can cause limb deformities.
Additionally, fetal limbs may be constrained by the amnion or fibrous ring within the uterine cavity, resulting in an intrauterine amputation (a condition referred to as "intrauterine amputation").
Due to uterine malformations, amniotic fluid deficiency can also lead to congenital malformations.
There are also reports of thalassemia leading to arterial embolism, resulting in cases of congenital amputation.
Cerebral palsy is an unchangeable fact, but it can be managed.
To enable patients to lead better lives.
The treatment of congenital hand deformities should primarily focus on improving function, followed by consideration of aesthetic improvement.
Certain types of polydactyly and syndactyly, among others, may also be considered for treatment with the purpose of improving appearance.
2. Deformities that impede growth, such as compound webbing and skin and soft tissue contractures, tend to worsen with the development of limbs, and it is essential to treat these deformities in a timely manner.
Anomalies that do not impede growth can be treated until the child is of school age.
When it comes to orthopedic surgery, especially those affecting skeletal development, it is best to undergo the procedure when bone growth has essentially ceased.
3. Prior to surgery for correction, it is important to consider the anticipated functional outcomes and additional structures (vascular, neural).
(1) Dysplasia of tendons, muscles, bones and joints.
4. Postoperatively, consciously strengthening guidance and exercise can compensate for its function, achieving good results.
The medical information provided in this text is for reference only.
In case of discomfort, it is advised to seek medical attention immediately for a definitive diagnosis and treatment at a physical examination.