Sir,
Congenital hand anomalies, although rare, incur significantly physical and psychological trauma. Timely diagnosis and appropriate treatment can change the future of the child. Therefore, it is essential for treating doctor to refer these children to appropriate specialists.
The aim of this study is to know the epidemiology of such anomalies at our centre over a 1-year period, i.e. to know the most common diagnosis, risk factors and associated anomalies.
This study includes patients of congenital hand anomalies who had come to our OPD in the last 1 year, i.e. from 1st September 2015 to 31st August 2016. A total of 80 patients were seen, of those, 59 were new and 21 had come for follow-up. Forty-two were female patients and 38 were males. Mean age of the patients was 33.8 months, with eldest being 13 years and youngest being 10 days. Sixty-six patients were Hindus, 13 Muslims and 1 Christian. Four patients were born out of consanguinous marriage (4th degree).
Mean age of mothers at the time of birth was 24.7 years. Forty-eight children were the first issue of their parents, 26 were the second issue, 5 were the third issue and 1 was the fourth issue. One pair of twins was noted. Higher incidence of anomalies in primipara was also noted in the study by Ghorpade et al.[1] Forty-three children were born as full-term vaginal delivery, while rest had delivered by caesarean section. In the study by Ghorpade et al., rate of caesarean delivery was 44% which in India is just 8.5%.[1,2] Thirty-four patients had birth weight ≤ 2.5 kg.
Ratio of bilateral hand involvement to right to left side is 5:1.6:1. Among all congenital anomalies, syndactyly was most common (31 cases). Next common was radial club hand [Table 1]. This is in contrast to studies done in the United States in a mid-Western Centre and at Ludhiana (India) where polydactyly is the most common, followed by syndactyly [Figures 1 and 2].[1,3]
Table 1.
Type of congenital hand anomaly
Figure 1.
Case of Poland syndrome with left symbrachydactyly
Figure 2.
Case of bilateral radial club hand
The most common associated anomalies in our series included Apert syndrome, Poland syndrome and isolated cleft palate. All associated anomalies are listed in [Table 2]. Vasluian et al. in their study done in Northern Netherland showed Patau syndrome to be the most common chromosomal anomaly while arthrogryposis was common among single gene anomalies. Cardiovascular system was most commonly affected.[4]
Table 2.
Type of associated anomaly
Forty-eight patients were operated among eighty patients in the last 1 year. The limitation of our study includes small sample size; therefore, the results may not be applicable to large population. This study however is still an interesting cross-sectional data of consecutive cases over a 1-year period.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
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