Kozin's 2003 Current Concepts Review surveys upper-extremity congenital anomalies for the practicing orthopaedic surgeon, covering embryologic signaling pathways, the Swanson/Frantz-O'Rahilly seven-category classification, and which specific anomalies demand systemic workup versus isolated musculoskeletal evaluation.
When you see radial deficiency — regardless of severity. Initiate cardiac, renal, and hematologic workup and send a chromosomal challenge test to rule out Fanconi anemia before aplastic anemia develops.
When you see ulnar deficiency, redirect your workup to the musculoskeletal exam alone, and use the thumb/first-web classification to guide reconstruction versus pollicization decisions.
Kozin's 2003 Current Concepts Review surveys upper-extremity congenital anomalies for the practicing orthopaedic surgeon, covering embryologic signaling pathways, the Swanson/Frantz-O'Rahilly seven-category classification, and which specific anomalies demand systemic workup versus isolated musculoskeletal evaluation.
When you see radial deficiency — regardless of severity. Initiate cardiac, renal, and hematologic workup and send a chromosomal challenge test to rule out Fanconi anemia before aplastic anemia develops.
When you see ulnar deficiency, redirect your workup to the musculoskeletal exam alone, and use the thumb/first-web classification to guide reconstruction versus pollicization decisions.