SURGICAL CLASSIFICATION OF CENTRAL DEFICIENCY ACCORDING TO THE THUMB WEB

A classification for congenital central deficiency is presented. In co ntrast to previous classification schemes, this proposed classificatio n is based on the characteristics of the thumb web, which are more imp ortant to the function of the hand than are the central deficiency fea tures. Five progressive narrowings of the thumb web are identified: no rmal web (type I), narrowed web (type II), syndactylized web (type III ), merged web (type IV), and absent web (type V). Forty-six central-de ficient hands were classified and reviewed. The progressive narrowing of the thumb web correlated with progressive severity of the central d efects. The proposed classification system guides and directs surgical recommendations.