Clinical classification and treatment strategy of the hand deformity in Poland syndrome

Objective To review and analyze the clinical morphologic characteristics of the hand deformity in Poland syndrome,and establish a new classification system and treatment strategy. Methods Sixty-three cases with Poland syndrome treated by the authors between February 2000 and August 2011 were evaluated retrospectively.The clinical morphologic characteristics of the hand deformity were systemically analyzed.Based on the severity degree of morphologic deformity,the Poland hand was classified into typical type and atypical type.Typical type was sub-classified into type Ⅰ,type Ⅱ,type Ⅲ,type Ⅳ and type Ⅴ,and atypical type was sub-classified into type Ⅰ,type Ⅱ and type Ⅲ.The deformed hands in each type were also summarized with respect to growth and development,syndactyly,X-ray features and impairment of functions.56 cases of them were treated surgically under the guidance of the new classification,and a new strategy for surgical treatment was established. Results A follow-up of 10.5 months on average (range from 6 to 18 months) postoperatively showed that the success rate of interdigital syndactyly welease was 100％.The major postoperative problems included scar contracture and web adhesion.Currently there were still no ideal methods for treatment of associated anomalies(such as short fingers,hypoplasia of forearm and upper arm,aplasia of digits,breast hypoplasia).Conclusion The hand deformities in Poland syndrome are complicated with multiple manifestations.The new classification system covers clinical and morphologic characteristics comprehensively,and offers a basis for options of surgical treatment of the deformed hand.The associated anomalies still need to be treated in the future. Key words: Poland syndrome;  Hand deformities, congenital;  Syndactyly;  Classification;  Treatment strategy