Classification of Hand Anomalies: Swanson Classification
1. Failure of formation: Transverse absence or longitudinal absence
Transverse absence also includes true transverse absence, symbrachdactyly. Longitudinal absence include Radial club hand, Ulnar club hand and cleft hand
2. Failure of differentiation: Eg., Camptodactyly, Clinodactyly, Syndactyly, symphalangism
3. Duplication: Eg, Preaxial and Postaxial polydactyly
4. Overgrowth: Eg, Macrodactyly
5. Undergrowth: eg, thumb hypoplasia
6. Congenital constriction band syndromes
7. General skeletal abnormalities
The Swanson Classification has been very popular. Recently, the Oberg Manske Tonkin Classification has been adopted by the International Federation of Societies for Surgery of the Hand (IFSSH) as the new Classification with better intraobserver and interobserver reliability. Better understanding of the embryology of the limb bud has led to this change.
Based on this Congenital Anomalies of Hand can be classified as Malformations, Deformations and Dysplasias which are then subclassified.
Hand development is known to occur in 3 axes- Proximal to Distal, Dorsal to Ventral, and Ulnar to Radial growth
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