Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2011 Sep;3(3):172-7. doi: 10.4055/cios.2011.3.3.172. Epub 2011 Aug 19.
For hand surgeons, the treatment of children with congenital differences of the upper extremity is challenging because of the diverse spectrum of conditions encountered, but the task is also rewarding because it provides surgeons with the opportunity to impact a child's growth and development. An ideal classification of congenital differences of the upper extremity would reflect the full spectrum of morphologic abnormalities and encompass etiology, a guide to treatment, and provide prognoses. In this report, I review current classification systems and discuss their contradictions and limitations. In addition, I present a modified classification system and provide treatment principles. As our understanding of the etiology of congenital differences of the upper extremity increases and as experience of treating difficult cases accumulates, even an ideal classification system and optimal treatment strategies will undoubtedly continue to evolve.
对于手部外科医生来说，治疗上肢先天性差异的儿童具有挑战性，因为所遇到的情况多种多样，但这项任务也很有意义，因为它为外科医生提供了影响儿童生长发育的机会。上肢先天性差异的理想分类系统应反映出形态异常的全貌，并包括病因、治疗指南和预后。在本报告中，我回顾了现有的分类系统，并讨论了它们的矛盾和局限性。此外，我还提出了一种改良的分类系统，并提供了治疗原则。随着我们对手部先天性差异病因的理解的增加，以及对治疗困难病例经验的积累，即使是一个理想的分类系统和最佳的治疗策略也无疑将继续发展。
