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Congenital anomalies of the upper extremities
Congenital malformations of hands about 7% of all diseases of the upper extremities.
Absence and hypoplasia of the upper extremity - severe pathology, fortunately it is rare. Variants of underdevelopment of the upper extremities are different.
Fokomeliya or Amelia - an anomaly of development, in which the upper limb is missing completely, or there is no shoulder and forearm, wrist and arm away from the immature and like fin seal. Sometimes, instead of a brush of the shoulder immature leaves only one finger. This condition is called peromeliya. Surgical treatment of anomalies such unpromising. Patients are usually well trained to use the abnormal limb. Prosthesis is performed to correct a cosmetic defect.
Ektomeliya - complete absence of one or two limbs or parts of limbs. The complete absence of limb prosthesis. In partial - is sometimes required surgical correction.
Hemimelia - an anomaly of development, in which there is no bottom of the limb (hand or wrist and forearm), and upper segments developed normally. Treatment consists of prosthetics.
Congenital anomalies of the individual segments of the upper extremity.
Congenital synostosis of the forearm bones or radioulnarny synostosis. Found this anomaly development is not often. In utero the radius and ulna forearm combined bridge, which subsequently ossifies. Jumper occurs in the upper arm and can be of different lengths. More common in boys. The child's hand is not rotated at the wrist, but flexion and extension of the elbow kept. This situation greatly complicates the patient's life, even his self.
Treatment initially conservative and is the development arm. Some patients may well adapt to this defect. If you can not develop a hand, surgical treatment is applied. With a slight adhesion of producing its dissection, with the amount of seam more than 4 cm have resorted to the removal of the radial bone. Surgical treatment is performed at the age of 3 years.
Congenital clubhand. Congenital clubhand occurs in violation of the forearm muscles or hypoplasia of radiation, at least the ulna.
Elbow clubhand develops, if the ulnar side of the forearm muscles are underdeveloped, the ulna is missing completely or partially. The simultaneous underdevelopment 4.5 fingers, the bones of the metacarpus and the wrist with ulnar side. Brush with this condition abruptly turned in the ulnar side (laterally), its function is compromised.
Radiation clubhand. This anomaly develops in the absence of the radius. The defect may be bilateral. Simultaneously, underdeveloped muscles of the forearm with radial side, the first finger of the hand, wrist bones with radial side. The brush is tilted toward the ulna (medially), its function is greatly impaired, and in the absence of the first finger brush can not bite subjects.
Treatment of congenital clubhand. Treatment of congenital clubhand involves many steps. Immediately after the birth of a child is prescribed massage, exercise therapy. In order to correct joint contractures plaster bandages are applied. The first operation performed at age 2. Then may need additional surgery.
Chronic subluxation of the wrist (Madelung's disease). It is rarely found an anomaly in which there is a malformation of the wrist joint. Deformation progresses gradually to 12-14 years is noticeable. Pain in this disease there. There is a distortion shtykoobraznoe brush, which is gradually increasing. Limited movement in the wrist joint. Treatment operative. Resect parts of the bones, followed by fixing them spoke. Then placing a plaster cast for a month and then prescribe physical therapy and exercise therapy.
Syndactyly. This anomaly of development in which there is complete or incomplete fusion of one or more fingers together. Hand function is disturbed. There is a cosmetic defect. Fusion may be soft tissue if only soft tissue are spliced, and bone. Fusion of normally developed fingers is called simple. The complex fusion occurs when fused fingers have independent developmental defects.
The most common cutaneous syndactyly. When the fingers are fused throughout. Most often fused third and fourth fingers. The membranous form occurs when the fingers are spliced together in the form of a skin bridge swimming membrane. In the form of bone syndactyly toes fused during one or all of the phalanges. Occasionally found nerazedinenie terminal phalanges - end-fusion.
Treatment of syndactyly. Conservative treatment is not used. Fingers separated surgically. Soft tissue syndactyly ordinary share at the age of 6 months. Operate complex defects after year. The fingers were separated, and the lack of tissue recovered through the brush or tissue with skin grafts. After surgery, a plaster impose Longuet, and then allocate physical therapy and exercise therapy.
Polydactyly. Polydactyly is a congenital anomaly of the fingers, which is from 6 to 10.Chasto occurring polydactyly - a split of the first finger, which can be full or bifurcated only nail phalange. Treatment of surgery. Abnormal fingers removed.
