Kozin Scott H, Zlotolow Dan A
Philadelphia, Pa. From Shriners Hospital for Children, Philadelphia.
Plast Reconstr Surg. 2015 Aug;136(2):241e-257e. doi: 10.1097/PRS.0000000000001499.
After reading this article, the participant should be able to: 1. Accurately diagnose congenital differences that affect the hand. 2. Develop a surgical plan for syndactyly with regard to timing of intervention to prevent progressive deformity and principles to restore the commissure. 3. List the potential complications following polydactyly reconstruction. 4. State the indications for pollicization for thumb hypoplasia.
Congenital conditions of the hand are commonly encountered in a pediatric hand surgery practice. The physician must be comfortable and have a sound understanding of the diagnosis and treatment algorithm. Certain diagnoses are inheritable and require genetic testing and/or genetic counseling. Appropriate referral is necessary to facilitate education about the congenital difference and its effect on subsequent generations. Syndactyly, polydactyly, thumb hypoplasia, and cleft hand are particularly commonplace and are discussed in this article. The treatment principles and surgical techniques are emphasized to maximize hand function and aesthetic outcome.
阅读本文后，参与者应能够：1. 准确诊断影响手部的先天性畸形。2. 制定并指手术计划，包括干预时机以预防渐进性畸形以及恢复指蹼的原则。3. 列出多指重建术后的潜在并发症。4. 阐述拇指发育不全的拇指化手术指征。
手部先天性疾病在小儿手外科临床实践中较为常见。医生必须熟悉并深入理解诊断和治疗流程。某些诊断具有遗传性，需要进行基因检测和/或遗传咨询。进行适当转诊有助于开展关于先天性畸形及其对后代影响的教育。并指、多指、拇指发育不全和裂手尤为常见，本文将对其进行讨论。重点强调治疗原则和手术技巧，以最大限度地提高手部功能和改善美观效果。
