Epidemiology of congenital upper limb anomalies in Stockholm, Sweden, 1997 to 2007: application of the Oberg, Manske, and Tonkin classification.
OBJECTIVE
To investigate the epidemiology of congenital upper limb anomalies (CULA) based on the newly proposed Oberg, Manske, and Tonkin (OMT) classification, to compare this classification with the International Federation of Societies for Surgery of the Hand (IFSSH) classification, and to provide incidence rates of the different CULA.


METHODS
In this study, the same 562 individuals with a CULA who were analyzed in a previous epidemiologic study based on the IFSSH classification were reclassified according to the OMT classification. All children identified with CULA and born in Stockholm County between January 1, 1997 and December 31, 2007 were included in the study. During the period there were 261,914 live births in Stockholm County, and the population of Stockholm County was 1,949,516 inhabitants at the end of the period. From medical records and available radiographs, all cases were analyzed regarding type of CULA, sex, affected side, associated nonhand anomalies, and occurrence among relatives. Individuals with right and left side anomalies belonging to different OMT subgroups were counted as 2 anomalies; thus, the material consisted of 577 CULA in 562 children.


RESULTS
It was possible to organize all CULA into the OMT classification. The largest main category was malformations (429 cases), followed by deformations (124 cases), dysplasias (10 cases), and syndromes (14 cases). We present the relation between the IFSSH and OMT classifications, elucidate difficulties within the OMT classification, and propose additions to the classification.


CONCLUSIONS
This study confirms that the OMT classification is useful and accurate, but also points out difficulties. With further refinements, we regard the OMT classification as a needed and appropriate replacement for the IFSSH classification.


METHODS
Diagnostic III.
Section of Hand Surgery, Department of Clinical Science and Education; and the Department of Hand Surgery, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. Electronic address: anna.gerber.ekblom@ki.se.
Anna Gerber
AG
Ekblom
Section of Hand Surgery, Department of Clinical Science and Education; and the Department of Hand Surgery, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Tobias
T
Laurell
Section of Hand Surgery, Department of Clinical Science and Education; and the Department of Hand Surgery, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Marianne
M
Arner
D003430:Cross-Sectional Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006228:Hand Deformities, Congenital / Q000145:classification / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D012042:Registries; D013548:Sweden; D013577:Syndrome; D038062:Upper Extremity Deformities, Congenital / Q000145:classification* / Q000453:epidemiology* / Q000235:genetics
Congenital upper limb anomalies; OMT classification; epidemiology