Pai G Mithun, Kamath B N Jagannath
Department of Hand Surgery, Kasturba Medical College, Manipal, India.
Manipal Academy of Higher Education, Manipal, India.
J Orthop. 2022 Mar 19;31:17-21. doi: 10.1016/j.jor.2022.03.005. eCollection 2022 May-Jun.
Congenital upper extremity anomalies are present in 1 in every 626 live births. They are mostly isolated phenomena but can also be associated with other congenital deformities and may be the only external feature of a syndromic entity. A study on it in India, especially the southern part, is limited. As the quality of life gets compromised, there is a need to identify and diagnose the anomalies at the earliest. Current study is aimed to identify congenital hand deformities among the school-going population in the coastal city of Mangalore.A cross sectional study was done in the schools in Mangalore city. By simple random sampling, 35 out of 70 schools were selected, and 10,000 children in age group of 5-15years were included by non-probability sampling after taking their consent from school authorities and parents. Data was analyzed by FISHER's exact test.
41 cases of congenital hand anomalies were identified with 23 boys and 18 girls. Twelve children had bilateral involvement. 28 cases where of polydactyly followed by four cases of acrosyndactyly with constriction band, three cases each of syndactyly and camptodactyly,one case of lobster hand and one case each of transverse deficiency of hand and forearm. Associated lower limb anomalies were seen in 9 cases. Familial associations were seen in 6 cases, and 1 polydactyly child had a downs syndrome association. All cases[4cases] of acrosyndactyly with constriction band syndrome were operated at childhood, and most other deformities were unoperated. Polydactyly[duplication] tops the list and needs further studies to look into genetic, environmental, and regional variations.
The prevalence of congenital hand difference in Mangalore is 41 per 10000 school-going children examined. . A future national registry in India should be the way forward to assess the true prevalence and risk factors.
先天性上肢异常在每626例活产儿中出现1例。它们大多为孤立现象，但也可能与其他先天性畸形相关，并且可能是综合征实体的唯一外部特征。在印度，尤其是南部地区，对此的研究有限。由于生活质量受到影响，需要尽早识别和诊断这些异常。当前研究旨在确定沿海城市芒格洛尔学龄人群中的先天性手部畸形。
在芒格洛尔市的学校开展了一项横断面研究。通过简单随机抽样，从70所学校中选取了35所，在征得学校当局和家长同意后，通过非概率抽样纳入了10000名5至15岁的儿童。数据采用费舍尔精确检验进行分析。
共识别出41例先天性手部异常，其中男孩23例，女孩18例。12名儿童为双侧受累。28例为多指畸形，其次是4例并指畸形伴束带，多指畸形和屈曲指畸形各3例，1例龙虾爪手，手和前臂横断性缺损各1例。9例伴有下肢异常。6例有家族关联，1例多指畸形儿童伴有唐氏综合征。所有4例并指畸形伴束带综合征患儿在儿童期接受了手术，大多数其他畸形未进行手术。多指畸形（重复）位居榜首，需要进一步研究以探讨遗传、环境和区域差异。
芒格洛尔先天性手部差异的患病率为每10000名接受检查的学龄儿童中有41例。印度未来应建立全国登记系统，以此来评估真实患病率和风险因素。
