Gerety E-L, Grant I, Hopper M A
Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Box 219, Cambridge, UK,
Skeletal Radiol. 2015 Apr;44(4):549-56. doi: 10.1007/s00256-014-2084-2. Epub 2014 Dec 19.
Congenital hand anomalies present a rare but important physical and emotional challenge for children and parents. Radiological imaging is important for accurate diagnosis, to aid decision making and to monitor changes in the growing hand. The goal of any treatment is to help the child achieve his/her maximum potential, to provide a useful hand with attention to cosmesis. We investigated the range of congenital hand anomalies imaged in a tertiary referral centre. We examined the timing of imaging and the key clinical questions.
The radiology imaging system was searched retrospectively for radiographs of congenital hand anomalies over a 6-year period. The images were reviewed and patient demographics, diagnosis and other imaging recorded.
Over 6 years, 85 patients had imaging. Twenty-three patients had bilateral problems and 11 had recognised syndromes. The most common abnormalities imaged were duplicated thumbs (28 %), followed by syndactyly (18 %). Children were first imaged as early as 1 day old, with the median age of initial imaging 12 months.
Thumb duplication and syndactyly are the most common conditions for which radiographs are requested at our hospital, although overall syndactyly is considered the most common congenital hand anomaly. For a variety of reasons, children are often imaged very early, before review by the Specialist in Children's Hand Surgery (despite surgery being unlikely before 1 year of age.) We discuss the classification systems and specific issues that hand surgeons want to know from the radiologists.
先天性手部畸形对儿童及其父母来说是一种罕见但重要的身体和情感挑战。放射影像学对于准确诊断、辅助决策以及监测生长中手部的变化至关重要。任何治疗的目标都是帮助孩子发挥其最大潜能，提供一只功能良好且注重美观的手。我们调查了在一家三级转诊中心成像的先天性手部畸形的范围。我们检查了成像时机和关键临床问题。
对放射影像系统进行回顾性检索，查找6年间先天性手部畸形的X线片。对图像进行审查，并记录患者人口统计学资料、诊断及其他影像学信息。
6年间，85例患者接受了成像检查。23例患者存在双侧问题，11例患有已确认的综合征。成像显示最常见的异常是多指畸形（28%），其次是并指畸形（18%）。儿童最早在出生1天就接受了首次成像检查，首次成像的中位年龄为12个月。
拇指多指畸形和并指畸形是我院最常要求拍摄X线片的疾病，尽管总体而言并指畸形被认为是最常见的先天性手部畸形。由于多种原因，儿童通常在接受儿童手外科专家复查之前就很早进行了成像检查（尽管1岁前不太可能进行手术）。我们讨论了手外科医生希望从放射科医生那里了解的分类系统和具体问题。
