Goldfarb Charles A, Wall Lindley B, Bohn Deborah C, Moen Patrick, Van Heest Ann E
Department of Orthopaedic Surgery, St Louis Shriners Hospital for Children and St Louis Childrens Hospital, Washington University School of Medicine, St. Louis, MO; Gillette Childrens Specialty Care, St. Paul, MN; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
Department of Orthopaedic Surgery, St Louis Shriners Hospital for Children and St Louis Childrens Hospital, Washington University School of Medicine, St. Louis, MO; Gillette Childrens Specialty Care, St. Paul, MN; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
J Hand Surg Am. 2015 Jan;40(1):127-32.e1-2. doi: 10.1016/j.jhsa.2014.10.038.
To examine the relative presentation frequency of children with upper limb congenital anomalies at 3 Midwestern referral centers using the Oberg, Manske, and Tonkin (OMT) classification and to assess the utility of this new classification system.
641 individuals with 653 congenital upper extremity anomalies were identified at 3 hospitals in 2 large metropolitan areas during a 1-year interval. Patients were identified prospectively and the specific upper extremity anomaly and any associated syndromes were confirmed using medical records and radiographs. We applied the OMT classification that categorizes anomalies using a dysmorphology outline as malformations, dysplasias, deformations, and syndromes, and assessed its utility and ease of use.
There were 480 extremities (74%) with a limb malformation including 184 involving the entire limb. Arthrogryposis was the most common of these (53 extremities). Anomalies affecting only the hand plate accounted for 62% (296) of the malformations. Of these, radial polydactyly (15%) was the most common specific anomaly, followed by symbrachydactyly (13%) and cleft hand (11%). Dysplasias were noted in 86 extremities; 55 of these were multiple hereditary exostoses. There were 87 extremities with deformations and 58 of these were trigger digits. A total of 109 children had a syndrome or association. Constriction ring sequence was most common. The OMT was straightforward to use and most anomalies could be easily assigned. There were a few conditions, such as Madelung deformity and symbrachydactyly, that would benefit from clarification on how to best classify them.
Malformations were the most common congenital anomalies in the 653 upper extremities evaluated over a 1-year period at 3 institutions. We were able to classify all individuals using the OMT classification system.
使用奥伯格、曼斯克和汤金（OMT）分类法，研究3个中西部转诊中心上肢先天性畸形患儿的相对就诊频率，并评估这一新分类系统的实用性。
在1年的时间间隔内，于2个大城市地区的3家医院识别出641例患有653例先天性上肢畸形的个体。对患者进行前瞻性识别，并使用病历和X光片确认具体的上肢畸形及任何相关综合征。我们应用OMT分类法，该分类法使用畸形学大纲将畸形分为畸形、发育异常、变形和综合征，并评估其实用性和易用性。
有480个肢体（74%）存在肢体畸形，其中184个涉及整个肢体。关节挛缩症是最常见的（53个肢体）。仅影响手板的畸形占畸形总数的62%（296个）。其中，桡侧多指畸形（15%）是最常见的具体畸形，其次是并指畸形（13%）和裂手畸形（11%）。86个肢体存在发育异常；其中55个是多发性遗传性骨软骨瘤。有87个肢体存在变形，其中58个是扳机指。共有109名儿童患有综合征或关联疾病。束带序列是最常见 的。OMT易于使用，大多数畸形可以轻松分类。有一些情况，如马德隆畸形和并指畸形，需要进一步明确如何进行最佳分类。
在3家机构为期1年的评估中，畸形是653例上肢中最常见的先天性畸形。我们能够使用OMT分类系统对所有个体进行分类。
