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Eight Chinese patients with congenital absence of the hand were treated with the Krukenberg procedure to provide a pinching function of the forearm bones. The rehabilitation program was simple and the functional results were satisfactory. We have selected three cases to illustrate the Krukenberg procedure and the indications for this operation, a procedure that is particularly suitable for the Chinese who are culturally adapted to chopstick functions.

There were 578 patients with more than 728 congenital anomalies of the upper limb seen in our center over a 10-year period. All anomalies were classified with the system recommended by the International Federation of Societies for Surgery of the Hand (IFSSH). Our results differ from other reported series with group III duplication anomalies being most common (35.9%) followed by group II (31.3%); group I (12.2%); group VII (9.3%), group VI (6.5%), group V (4.3%), and group IV (0.5%). Variations among different ethnic groups are significant although some apparent differences can also result from different patient referral patterns and method of classification. The classification adopted by the IFSSH was found to be practical in the majority of cases. However, difficulties were encountered in the classification of multiple anomalies; group VII cases and the complex spectrum of atypical cleft hand, brachysyndactyly, and transverse arrests. In addition, many common anomalies had not been included in the classification.

Three hundred twenty-six patients with 396 congenital upper limb anomalies are classified according to the system adopted by the International Federation of Societies for Surgery of the Hands. The relative incidence of each separate anomaly is listed and compared with that of other series. Two hundred cases are also analyzed with respect to the family history, pregnancy history, neonatal history, and associated anomalies and the results are discussed. Significant racial differences were found in the incidence of polydactyly, syndactyly, anomalies associated with syndromes, and transverse arrests. The incidence of polydactyly is higher in this series than in comparable western series.

A 39-year-old tailor was seen initially with primary extranodal malignant lymphoma of the deep soft tissues of the right hand. The diagnosis was confirmed by immunocytochemical staining technique on the biopsy material. Review of the literature showed that this is a rare presentation. The prognosis is related to histologic grading. The patient received radiotherapy and the lesion responded rapidly. He was free of the disease 1 year later.

Preaxial polydactyly constitutes the most common group of congenital anomalies of the hand among the Chinese population of Hong Kong. Ninety-five cases from the Orthopaedic/Plastic and Reconstructive Surgery Unit, Princess Margaret Hospital, Hong Kong (March 1976 to March 1981), were reviewed. The cases were classified according to Wassel's classification (1969) into seven types. The most common category was type IV followed by types II, V, III, VII, I, and VI. The treatment of each type was analyzed. Bilhaut's procedure was satisfactory for type I, and a modified technique was used for types II and III. A method of shaving the incongruous articular cartilage was used in type IV. Removal of the extra digit and osteotomy of the metacarpal usually were required for type V. The experience with types VI and VII was too limited for assessment. Short-term results (1 to 6 years) have been satisfactory, but follow-up until skeletal maturity to assess the ultimate functional and cosmetic results is necessary.