Congenital malformations and deformities of upper and lower limbs

Developmental anomalies are deviations that do not fit into the concept of “normal” body structure. Congenital anomalies are laid down in the womb during the period from 3 to 10 weeks of pregnancy. Some deviations develop after birth with organ growth.

At Ladisten, the center of modern cosmetic orthopedics and traumatology, malformations of limbs of different natures in patients of different ages are corrected.

Major limb malformations

Limb malformations have a complex and broad classification. They can be divided into two large groups:

• Defectiveness of limbs. This includes congenital absence (amputation) of arms, legs or fingers. A limb may be missing completely, or some part of it may be missing (for example, forearms, feet, etc.).
• Malformations of limbs caused by doubling, splicing, the presence of additional elements (for example, presence of a sixth finger or spliced fingers on the hand).

Upper limb malformations

Anomalies of this group include any abnormalities in the skeleton of the shoulder girdle and arms.

If we talk about developmental abnormalities of the upper limbs, the classification developed by The American Society for Surgery of the Hand (ASSH) and the International Federation of Societies for Surgery of the Hand (IFSSH) shows the following directions:

1. Lateral and transverse structural defects.
2. Impaired differentiation of bone and soft tissue.
3. Polydactyly or doubling.
4. Excessive development of segments.
5. Inadequate development.
6. Underdevelopment of hands or fingers.
7. Congenital constrictions.
8. General pathology of the skeleton.

Major diseases include:

• malformations of the hand – its complete absence, inability to move the wrist or straighten it;
• absence of other parts, such as forearms or fingers;
• phocomelia – seal-like limbs;
• syndactyly – spliced fingers;
• stenosing ligamentitis – inability to straighten the finger;
• camptodactyly – a part of the limb is missing due to intrauterine constrictions.
• giant or very long fingers.

Lower limb malformations

Anomalies in the development of the lower limbs are similar to those of the upper ones. Congenital malformations of the lower extremities are identified by codes Q74.1-Q74.9 in ICD-10.

Major diseases include:

• developmental malformations of the foot – its partial or complete absence;
• underdevelopment of the hip;
• dysplasia of the hip joint;
• valgus and varus deformities;
• absence of the patella;
• dislocations;
• nonunion (also called “false joint”).

Causes

Abnormalities in the development of limbs in children are laid down in the womb. The main reasons are:

• genetic factor;
• mutations;
• infections at 3-7 weeks of pregnancy;
• intake of some kinds of medications;
• occurrence of constrictions;
• alcohol, drug and tobacco abuse.

It is not always possible to find out the exact cause, but effective treatment still exists.

Prevention

Limb malformations are mostly congenital defects. As a preventive measure, it is necessary to lead a healthy lifestyle and to undergo ultrasound scans on a routine basis for the timely detection of pathology. Some situations can be corrected while the fetus is still in the womb. Nutrition should be balanced during pregnancy in order for the fetus to receive enough vitamins and minerals for development. Ecology and hygiene are also important. Infections can cause defects.

Limb restoration

Lower limb malformations can be corrected with the help of modern surgery. The same applies to the arms: Ladisten offers multi-type reconstructive surgical manipulations for various pathologies. In each case, the treatment is individual. The clinic uses all modern techniques and reconstruction possibilities. In particular, operations involving the use of a microscope are performed. During the reconstruction, the limb is restored to the most natural anatomical appearance. Blood flow, tendons and nerve fascicles are restored.

In case of malformations of the body parts, surgery is aimed at restoring them, balancing their length, correcting defects. If the anomaly is congenital, it is better to correct it in childhood. The child adapts to the “new” organ more easily, learns to use it and gets used to a normal life while having a healthy body structure.

Sourses 

1. Orthopedics, traumatology and prosthetics. 2013. No. 2: 102–108
2. Simeon A. Boyadjiev Boyd, MD, University of California, Davis.
3. Congenital limb pathologies Popkov DA .. “On the classification of congenital malformations of the lower extremities, accompanied by shortening” The genius of orthopedics, no. 1, 2004, pp. 9-16.