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An attempt to classify the malformations of the hand based on morphogenetic criteria

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Summary

At the present time there exist two internationally accepted classifications for the grouping of malformations of extremities: The anatomically and clinically orientated classification by Swanson (1976) and the anatomically and genetically founded classification by Temtamy (1966) and Temtamy and McKusick (1969 and 1978). In the introduction, the phylogeny and ontogeny of the extremities are considered. Under the aspect of phylogeny and ontogeny the groups I Failure of formation of parts, II Failure of differentiation (separation) of parts, III Duplication and VI Congenital constriction band syndrome of Swanson's (1976) classification are discussed. It is found that this anatomically founded classification is largely confirmed in the use of latest morphogenetic criteria and that only few modifications may be called for. In the light of present-day genetic knowledge the use of new classifications published in the literature, for example that of the cleft hand, appear doubtful, as they are based on mere by clinical criteria.

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References

  1. Sachsse H (1968) Die Erkenntnis des Lebendigen. Vieweg, Braunschweig

    Google Scholar 

  2. Saint-Hilaire JG (1836) Histoire générale et particulière des anomalies de l'organisation chez l'homme et les animaux. Tome II. Baillière Paris, p 206

  3. Kelikian H (1974) Congenital deformities of the hand and forearm. Saunders Co, Philadelphia

    Google Scholar 

  4. Swanson AB, Barsky AJ, Entin MA (1968) Classification of limb malformation on the basis of embryological failures. Surg Clin North Am 48:1169–1179

    Google Scholar 

  5. Swanson AB (1971) Severe congenital malformations of the upper limb, considerations for classification and treatment. In: Cramer LM, Chase RH (eds) Symposium on the hand, vol. 5. Mosby Co, St. Louis, pp 132–149

    Google Scholar 

  6. Swanson AB (1976) A classification for congenital limb malformations. J Hand Surg 1:8–22

    Google Scholar 

  7. Kay HW, Day HJB, Henkel HL, Krüger LM, Lamb DW, Marquardt E, Mitchell R, Swanson AB, Willert HG (1978) Eine internationale Terminologie zur Klassifikation angeborener Gliedmaßenfehlbildungen. Arch Orthop Trauma Surg 93:1–19

    Google Scholar 

  8. Temtamy SA (1966) Genetic factors in hand malformations. Ph.D. Thesis, Johns Hopkins University, Baltimore

    Google Scholar 

  9. Temtamy SA, McKusick V (1978) The genetics of hand malformations. Birth defects. Original article series, Vol. XIV, No.3, The National Foundation — March of Dimes

  10. Frantz ChH, O'Rahilly R (1961) Congenital skeletal limb deficiencies. J Bone Joint Surg [Am] 43:1202–24

    Google Scholar 

  11. Willert HG, Henkel HL (1976) Pathologisch-anatomische Prinzipien bei Extremitätenfehl bildungen, dargestellt am Beispiel der Finger. Z Orthop 107:663–75

    Google Scholar 

  12. Flatt AE (1970) A test of a classification of congenital anomalies of the upper extremity. Surg Clin North Am 50:509–16

    Google Scholar 

  13. Blauth W, Schneider-Sickert F (1976) Handfehlbildungen. Springer, Berlin Heidelberg New York

    Google Scholar 

  14. Buck-Gramcko D (1981) Angeborene Fehlbildungen der Hand. In: Nigst H, BuckGramcko D, Millesi H (Hrsg) Handchirurgie Thieme, Stuttgart, pp 12.1–111

    Google Scholar 

  15. Tada K, Egawa T, Ono K (1977) The carpus in congenital anomalies of the hand. Acta Orthop Scand 48:592–99

    Google Scholar 

  16. Watari S, Tsuge K (1979) A classification of cleft hands, based on clinical findings. Theory of developmental mechanism. Plast Reconstr Surg 64:381–9

    Google Scholar 

  17. Miura T (1981) A clinical study of congenital anomalies of the hand. The Hand 13:59–68

    Google Scholar 

  18. Nutt JN, Flatt AE (1981) Congenital central deficit. J Hand Surg 6:48–60

    Google Scholar 

  19. Lösch GM, Schrader M (1982) Fehlbildungen der Hand. In: Baumgartl F, Kremer K, Schreiber HW (Hrsg) Spezielle Chirurgie für die Praxis, Bd III, Teil 3. Thieme, Stuttgart, pp 163–272

    Google Scholar 

  20. Temtamy SA, McKusick VA (1969) Synopsis of hand malformations with particular emphasis on genetic factors. In Clinical Delineation of Birth Defects, III. Limb Malformations. Original Article Series. Bergsma D (ed) New York, 1969. National Foundation — March of Dimes, pp 125–185

    Google Scholar 

  21. Gregory WK, Raven HC (1941) Studies on the origin and early evolution of paired fins and limbs. Ann NY Acad Sci 42:273–300

    Google Scholar 

  22. Seichert V (1973) Relative tissue shifts in early development of the wing and limb primordia in the chick. Folia Morphol (Praha) 21:243–246

    Google Scholar 

  23. Seichert V (1976) Relationships in the developing body wall and limb bud blastemas of the chick embryo. Folia Morphol (Praha) 24:330–334

    Google Scholar 

  24. Christ B, Jacob HJ, Jacob M (1974) Über den Ursprung der Flügelmuskulatur. Experimentelle Untersuchungen mit Wachtel- und Hühnerembryonen. Experientia 30:1446–1448

    Google Scholar 

  25. Christ B, Jacob HJ, Jacob M (1977) Experimental analysis of the origin of the wing musculature in avian embryos. Anat Embryol 150:171–186

    Google Scholar 

  26. Dhouailly D, Kieny M (1972) The capacity of the flank somitic mesoderm of early bird embryos to participate in limb development. Dev Biol 28:162–175

    Google Scholar 

  27. Steiner H (1935) Beiträge zur Gliedmaßentheorie: Die Entwicklung des Cheiropterygium aus dem Ichtyopterygium. Rev Suisse Zool 42:715–729

    Google Scholar 

  28. Steiner H (1942) Der Aufbau des Säugetier-Carpus und -Tarsus nach neueren embryologischen Untersuchungen. Rev Suisse Zool 49:217–223

    Google Scholar 

  29. Ihle JEW, van Kampen PN, Nierstrasz HF, Versluys J (1927) Vergleichende Anatomie der Wirbeltiere. Reprint 1971. Springer, Berlin Heidelberg New York

    Google Scholar 

  30. Gabriel ML (1946) The effect of local application of colchicine on Leghorn and polydactylous chick embryos. J Exp Zool 101:340–350

    Google Scholar 

  31. Saunders JW, Gasseling MT (1963) Trans-filter propagation of apical ectoderm maintenance factor in the chick embryo wing bud. Dev Biol 7:64–67

    Google Scholar 

  32. Lösch GM (1970) Syndaktylien. Normale und Pathologische Anatomie. In: Bargmann W, Doerr W (Hrsg) Monographien in zwangloser Folge, Heft 23. Thieme, Stuttgart

    Google Scholar 

  33. Lösch GM (1980) Formal genesis of syndactyly. In: Merker H-J, Nau H, Neubert D (eds) Teratology of the limbs. 4th symposium on prenatal development. de Gruyter, Berlin New York, pp 417–430

    Google Scholar 

  34. Milaire J (1965) Aspects of limb morphogenesis in mammals. Organogenesis. Haan and Ursprung (eds). New York, pp 283–300

  35. Čihák R (1980) Lehrbuch der Anatomie für Studenten der Medizin, I. Teil: Allgemeine Anatomie und Bewegungsapparat. Stattlicher Pädagogischer Verlag, Prag

    Google Scholar 

  36. Langmann J (1977) Medizinische Embryologie, 5. Aufl. Thieme, Stuttgart

    Google Scholar 

  37. Wolpert L (1978) Cell position and cell lineage in pattern formation and regulation. In: Stem cells and tissue homeostasis. British Society for Cell Biology Symposium 2. Cambridge University Press, London, New York, Melbourne, pp 29–47

    Google Scholar 

  38. Meinhardt H (1980) Developmental control of spatial sequences of structures. In: Merker H-J, Nau H, Neubert D (eds) Teratology of the limbs. 4th symposium on prenatal development. de Gruyter, Berlin New York, pp 1–10

    Google Scholar 

  39. Needham J (1950) Biochemistry and morphogenesis. University Press, Cambridge

    Google Scholar 

  40. Saunders JW (1948) The proximo-distal sequence of origin of the parts of the chick wing and the role of the ectoderm. J Exp Zool 108:363–403

    Google Scholar 

  41. Seichert V (1966) Differential growth pattern in the chick embryo wing bud between the 3rd, 5th and 7th day of incubation. Folia Morphol (Praha) 14:325–334

    Google Scholar 

  42. Jelînek R, Rychter H, Seichert V (1970) Syndrome of caudal regression in the chick embryo. Folia Morphol (Praha) 18:125–137

    Google Scholar 

  43. O'Rahilly R (1951) Morphological patterns in limb deficiencies and duplications. Am J Anat 89:135

    Google Scholar 

  44. Kay HW (1975) The proposed International Terminology for the classification of congenital limb deficiencies. Dev Med Child Neurol [Suppl] 34:17

    Google Scholar 

  45. Müller W (1937) Die angeborenen Fehlbildungen der menschlichen Hand. Thieme, Leipzig

    Google Scholar 

  46. Grebe H (1958) Spalthand — Spaltfuß, Ektrodaktylie. In: Schwalbe E, Gruber GB (Hrsg) Die Morphologie der Mißbildungen des Menschen und der Tiere, Teil III. Fischer, Jena

    Google Scholar 

  47. Werthemann A (1952) Die Entwicklungsstörungen der Extremitäten. In: Lubarsch O, Nenke F, Rössle R (Hrsg) Handbuch der speziellen pathologischen Anatomie und Histologie, Bd. IX/6. Springer, Berlin Heidelberg New York

    Google Scholar 

  48. Gruber BG (1958) Über Hyperdaktylie, Polydaktylie, Diplocheirie und Diplopodie, Hypermelie, Oligodaktylie und Defekte von Röhrenknochen. In: Schwalbe E, Gruber BG (Hrsg) Die Mißbildungen des Menschen und der Tiere, Teil III. Fischer, Jena pp 720–777

    Google Scholar 

  49. McKusick VA (1971) Mendelian inheritance in man, 3rd edn. Johns Hopkins University Press, Baltimore London

    Google Scholar 

  50. McKusick VA (1978) Mendelian inheritance in man, 5th edn. Johns Hopkins University Press, Baltimore London

    Google Scholar 

  51. Lösch GM, Duncker HR (1971) Acrosyndactylism. Transactions Fifth World Congress of Plastic Surgery. Butterworth, London, pp 671–676

    Google Scholar 

  52. Lösch GM, Dunkcer HR (1972) Anatomy and surgical treatment of syndactylism. Plast Reconstr Surg 50:167–73

    Google Scholar 

  53. Lösch GM, Schrader M, Eckert P (1980) Fehlbildungssyndrom mit Schnürfurchen, Pseudoligamenten, akralen Defekten und Syndaktylien. Diagnose und Therapie. Z Kinderchir [Suppl] 30:85–89

    Google Scholar 

  54. Wehr C (1982) Fehlbildungssyndrom mit Schnürfurchen, Pseudoligamenten, akralen Defekten und Syndaktylien. Diss Lübeck

  55. McKenzie J (1975) Amniotic bands. British Society for Developmental Biology, Symposium 2: The early development of mammals. University Press, Cambridge

    Google Scholar 

  56. Čihák R (1976) Diskussionsbemerkung anläßlich der 7. Tagung der Vereinigung der Deutschen Plastischen Chirurgen, 15.–18. Sept, Lübeck-Travemünde

  57. Lenz W (1980) Approaches to classification of limb defects. In: Merker HG, Nau H, Neubert D (eds) Teratology of the limbs, 4th symposium on prenatal development. de Gruyter, Berlin New York, pp 412–415

    Google Scholar 

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Author notes

  1. G. M. Lösch

    Present address: Klinik für Plastische Chirurgie der Medizinischen Hochschule, Ratzeburger Allee 160, D-2400, Lübeck 1, Germany

Authors and Affiliations

  1. Klinik für Plastische Chirurgie der Medizinischen Hochschule, Lübeck

    G. M. Lösch & M. Schrader

  2. Abteilung für Handchirurgie und Plastische Chirurgie, Berufsgenossenschaftliche Unfallklinik, Hamburg, Germany

    D. Buck-Gramcko

  3. Anatomický Ustav, Fakulty Vseobecného Lékarstvi, University Karlovy, Praha, CSSR

    R. Cihák & V. Seichert

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  1. G. M. Lösch
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  2. D. Buck-Gramcko
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  3. R. Cihák
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  4. M. Schrader
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  5. V. Seichert
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Lösch, G.M., Buck-Gramcko, D., Cihák, R. et al. An attempt to classify the malformations of the hand based on morphogenetic criteria. Chir Plastica 8, 1–18 (1984). https://doi.org/10.1007/BF00266855

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  • DOI: https://doi.org/10.1007/BF00266855

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