Synpolydactyly of the hand: a radiographic classification. (March 2016)

• Record Type: Journal Article
• Authors: Wall, L. B.; Bae, D. S.; Oishi, S. N.; Calfee, R. P.; Goldfarb, C. A.
• Is Part Of: Journal of hand surgery. Volume 41:Number 3(2016:Mar.)
• Page Start: 301
• Page End: 307
• Publication Date: 2016-03
• Subjects: Polydactyly -- syndactyly -- classification -- reliability -- radiograph; 617.575059
• DOI: 10.1177/1753193415598281
• Languages: English
• ISSNs: 1753-1934

Abstract

Synpolydactyly is an uncommon congenital anomaly characterized by polydactyly with syndactyly in the central hand. The purpose of this investigation was to develop and assess the reliability of a radiographic classification system for synpolydactyly. We identified 56 hands with central synpolydactyly and developed a radiographic classification system that categorizes by the location within the hand, the bony level of polydactyly, and the presence of a delta phalanx. Four paediatric hand surgeons independently reviewed each radiograph to establish reliability. There was exact agreement among raters in 40 cases (71%). The inter-rater reliability was 0.97 and intra-rater reliability was at least 0.87. Seven of 16 bilateral cases had symmetric deformity classification. The most common presentations were types 1A and 2A. We present a new, reliable radiographic classification system for synpolydactyly that will allow improved communication between clinicians and serve as a foundation for future investigations. Level of Evidence: 2