J Minguella-Solá1, M Cabrera-González. 1. Servicio de Ortopedia y Traumatología Infantil, Hospital Universitario Sant Joan de Déu, Esplugues de Llobregat, Barcelona.
Abstract
OBJECTIVE: The purpose of this study was to analyze the different hand anomalies observed in Poland's syndrome. PATIENTS AND METHODS: Thirty-eight clinical histories were revised. There were 28 boys and 10 girls. In 18 cases the right side was affected and in 20 cases the left side. Special attention was placed on the analysis of the anatomical hand findings, in both the clinical and radiographic studies. The patients were classified into 5 types: Type 1, without syndactyly; type 2 syndactyly and hypoplastic or aplastic middle phalanx; type 3 or "shovel hand" with complete syndactyly also affecting the thumb; type 4 longitudinal deficiency of some digits or radius and type 5 transversal absence. RESULTS: Four cases presented associated chest wall anomalies. We have observed four cases of type 1, 25 cases of type 2 (65.7%), 5 cases of type 3, 3 cases of type 4 and one case of type 5. The middle phalanx was hypoplastic in 15 cases, aplastic in another 15 cases and combined hypo and aplastic in 4 cases. In 18 hands we observed two fissure plates in metacarpals. CONCLUSIONS: 1) We did not observe any side predominance.) Two fissure plates in the first metacarpus is frequently observed (78.2%). 3) We propose a classification according to the anatomical hand anomalies.
OBJECTIVE: The purpose of this study was to analyze the different hand anomalies observed in Poland's syndrome. PATIENTS AND METHODS: Thirty-eight clinical histories were revised. There were 28 boys and 10 girls. In 18 cases the right side was affected and in 20 cases the left side. Special attention was placed on the analysis of the anatomical hand findings, in both the clinical and radiographic studies. The patients were classified into 5 types: Type 1, without syndactyly; type 2 syndactyly and hypoplastic or aplastic middle phalanx; type 3 or "shovel hand" with complete syndactyly also affecting the thumb; type 4 longitudinal deficiency of some digits or radius and type 5 transversal absence. RESULTS: Four cases presented associated chest wall anomalies. We have observed four cases of type 1, 25 cases of type 2 (65.7%), 5 cases of type 3, 3 cases of type 4 and one case of type 5. The middle phalanx was hypoplastic in 15 cases, aplastic in another 15 cases and combined hypo and aplastic in 4 cases. In 18 hands we observed two fissure plates in metacarpals. CONCLUSIONS: 1) We did not observe any side predominance.) Two fissure plates in the first metacarpus is frequently observed (78.2%). 3) We propose a classification according to the anatomical hand anomalies.