Swanson et al tried to classify congenital hand anomalies according to the genetic cause and reported his classification in 1976. Since then, modifications on this classification were made and this classification was adopted by the International Federation of Society for Surgery of the Hand (IFSSH). It has been used widely as an IFSSH classification. It is relatively easy to use this classification, but it has its own limitations. The biggest one occurs in the classification of ectrodactyly. In order to solve these problems, the authors conducted clinical ad experimental studies and found that there should be at least four different types of teratogenic mechanisms of congenital defect of the digits. The first one is longitudinal deficiencies due to mesenchymal cell death in an early developmental stage; the second is abnormal induction of digital ray numbers in the hand plate including cleft hand, central polydactyly and syndactyly. The third is constriction band syndrome, which is caused after digital radiations have been formed, and the fourth is transverse deficiency, in which the critical period is not known. Based on these studies, the author modified IFSSH classification and it was adopted by the Japanese Society for Surgery of the Hand and is called Japanese modification of the IFSSH classification (Japanese modification). In this paper, the author introduced the Japanese modification of the IFSSH classification and described some recommendations.

Chairman of the Sapporo Hand Surgery and Congenital Hand Differences Center Orthopaedic Hokushin higashi Hospital

Classification of congenital differences of the upper extremity

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