Uzun Hakan, Özdemir Fethiye Damla Menkü, Üstün Galip Gencay, Sakarya Ahmet Hamdi, Bitik Ozan, Aksu Ali Emre
From the Department of Plastic Reconstructive and Aesthetic Surgery, Hacettepe University Faculty of Medicine, Sihhiye.
Department of Plastic Reconstructive and Aesthetic Surgery, Ankara Education and Training Hospital, Altındağ, Ankara.
Ann Plast Surg. 2020 Sep;85(3):245-250. doi: 10.1097/SAP.0000000000002397.
Although the Oberg-Manske-Tonkin (OMT) classification has been recommended by the International Federation of Societies for Surgery of the Hand owing to some insufficiencies of the Swanson classification system, it has not achieved a universal adoption by hand surgeons. In this study, we hypothesize that the OMT classification can be used easily to classify congenital upper extremity anomalies. We also aim to make epidemiological analysis of congenital upper extremity anomalies with the OMT classification and to compare the applicability of the OMT and the Swanson classifications.
We retrospectively analyzed 711 patients and 833 extremities operated on between 2012 and 2017. Photographs, plain x-rays, and brief medical histories of the patients were evaluated by 4 plastic surgeons. Two independent evaluations were made by each surgeon in 1-month interval using these classification systems.
Total number of upper extremity anomalies recorded was 1050. Of the 711 patients operated on, 122 had bilateral anomalies. The anomalies were identified in 833 extremities because many extremities had more than a single diagnosis. We were able to classify all of the anomalies within the OMT classification. The OMT classification gives better reliability results compared with the Swanson classification according to intrarater and interrater reliabilities.
Compared with the Swanson classification system based on phenotypic evaluation of the extremity, the OMT classification system is easier to apply and the association of the anomaly with the embryologic origin during evaluation is possible. We believe that multiple studies from different centers will boost the international acceptance of the OMT classification.
尽管由于Swanson分类系统存在一些不足，国际手外科学会联合会推荐使用奥伯格-曼斯克-汤金（OMT）分类，但它尚未被手外科医生普遍采用。在本研究中，我们假设OMT分类能够轻松用于对先天性上肢畸形进行分类。我们还旨在使用OMT分类对先天性上肢畸形进行流行病学分析，并比较OMT分类和Swanson分类的适用性。
我们回顾性分析了2012年至2017年间接受手术的711例患者和833个肢体。4名整形外科医生对患者的照片、X线平片和简要病史进行了评估。每位医生使用这些分类系统在1个月的间隔内进行了两次独立评估。
记录的上肢畸形总数为1050例。在接受手术的711例患者中，122例有双侧畸形。在833个肢体中发现了这些畸形，因为许多肢体有不止一种诊断。我们能够将所有畸形归入OMT分类。根据评分者内和评分者间的可靠性，与Swanson分类相比，OMT分类给出了更好的可靠性结果。
与基于肢体表型评估的Swanson分类系统相比，OMT分类系统更易于应用，并且在评估过程中能够将畸形与胚胎起源联系起来。我们相信来自不同中心的多项研究将提高OMT分类在国际上的认可度。
