Retrospective Study for Congenital Hand and Upper Extremity Malformations in Upper Egypt During The Last Twenty Years

Background: Congenital limb malformations rank behind congenital heart disease as the most common birth defects observed in infants. These malformations can occur as isolated malformations, combined with another hand and/or foot, or as part of a syndrome. The aim of this work was to classify the different types of congenital hand and upper extremity malformations according to Swanson's classification, study the frequency of each type, and present some of the previously reported and operated cases. Methods: This retrospective study was carried out on 394 patients of all ages, from younger than 1 month to older than 18 years old, both sexes, with hand and upper limb anomalies. Data were extracted from the hospital's medical paper records included: Patient demographics, type of anomaly using Swanson’s classification system, age of first presentation, surgical Interventions, radiological investigations, and photographic documentation. Results: A significant portion (53%) of the cases underwent surgical intervention. Regarding Swanson Classification th failure of differentiation was the most frequent category (56.6%), followed by duplication (21.3%). Constriction band syndrome and generalized abnormalities were rare. Regarding type of anomalies syndactyly was the most common anomaly (47.2%), followed by polydactyly (21.3%). Conclusions: This study provided a comprehensive analysis of congenital upper limb anomalies in the last twenty years, with several key findings, Syndactyly and failure of differentiation were most common, with many cases requiring surgery. Regional variations in gender distribution and polydactyly patterns were noted.