{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:06:03Z","timestamp":1789643163000,"version":"4.0.0"},"reference-count":22,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0Several European countries offer nationwide prenatal ultrasound screening for fetal anomalies. Few studies have examined prenatal detection of upper limb anomalies, and existing reports originate exclusively from high\u2011volume centers outside Europe. We aimed to assess the timing of diagnosis in patients with all Oberg\u2013Manske\u2013Tonkin diagnoses except tumorous dysplasias referred to the largest specialized unit in Norway, investigate prenatal detection rates, and explore associations between patient\u2011 and hospital\u2011related factors and prenatal detection.Methods:\u00a0We extracted data on timing of diagnosis according to Oberg\u2013Manske\u2013Tonkin phenotype, and patient- and hospital-related variables from the CULA (congenital upper limb anomaly) North Oslo Registry from 2018 to 2025. For patients with anomalies detected prenatally or at birth, we analyzed associations between patient- and hospital-related factors and prenatal detection rate by multivariable logistic regression.Results:\u00a0703 consecutive patients were enrolled. 402 (57%) patients had their anomaly detected at birth and 252 (36%) later in life. Prenatal ultrasonography detected the upper limb anomaly in 49 (7.0%) of the patients. Among 426 patients with anomalies visible at birth whose mothers had at least 1 prenatal ultrasound scan, the examination detected the anomaly in 49 (12%). Among phenotypes observed in more than 5 patients, congenital contractures (amyoplasia, distal arthrogryposis), reduction deficiencies (transverse, radial, ulnar), and ulnar polydactyly had the highest detection rates. Prenatally detected cases were more often born in university hospitals and more frequently had bilateral upper limb involvement and\/or associated anomalies than those diagnosed at birth.Conclusion:\u00a07.0% of the upper limb anomalies were detected prenatally, 57% at birth, and 36% later in life. Prenatal detection rates were lower than those reported from larger non-European hand units, likely due to the inclusion of all upper limb anomaly diagnoses in this study and Norway\u2019s decentralized prenatal care system.<\/jats:p>","DOI":"10.2340\/17453674.2026.46807","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:58:41Z","timestamp":1789642721000},"source":"Crossref","is-referenced-by-count":0,"title":["Time of diagnosis of congenital upper limb anomalies: a cohort study of 703 patients from a local registry in Norway"],"prefix":"10.2340","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8884-3859","authenticated-orcid":false,"given":"Ida N","family":"Sletten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona I","family":"Winge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarkko","family":"Jokihaara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"168470","doi-asserted-by":"crossref","unstructured":"Ekblom A G, Laurell T, Arner M. Epidemiology of congenital upper limb anomalies in Stockholm, Sweden, 1997 to 2007: application of the Oberg, Manske, and Tonkin classification. J Hand Surg Am 2014; 39(2): 237-48. doi: 10.1016\/j.jhsa.2013.11.014.","DOI":"10.1016\/j.jhsa.2013.11.014"},{"key":"168471","doi-asserted-by":"crossref","unstructured":"Bae D S, Barnewolt C E, Jennings R W. Prenatal diagnosis and treatment of congenital differences of the hand and upper limb. J Bone Joint Surg Am 2009; 91(Suppl 4): 31-9. doi: 10.2106\/jbjs.I.00072.","DOI":"10.2106\/JBJS.I.00072"},{"key":"168472","doi-asserted-by":"crossref","unstructured":"Dicke J M, Piper S L, Goldfarb C A. The utility of ultrasound for the detection of fetal limb abnormalities: a 20-year single-center experience. Prenat Diagn 2015; 35(4): 348-53. doi: 10.1002\/pd.4546.","DOI":"10.1002\/pd.4546"},{"key":"168473","doi-asserted-by":"crossref","unstructured":"Gray B L, Calfee R P, Dicke J M, Steffen J, Goldfarb C A. The utility of prenatal ultrasound as a screening tool for upper extremity congenital anomalies. J Hand Surg Am 2013; 38(11): 2106-11. doi: 10.1016\/j.jhsa.2013.08.091.","DOI":"10.1016\/j.jhsa.2013.08.091"},{"key":"168474","doi-asserted-by":"crossref","unstructured":"O\u2019Keefe D, Kennedy J, McCombe D, Coombs C, Hui L, Wilks D, et al. Pre-natal and post-natal diagnosis of congenital upper limb differences: the first 3 years of the Australian Hand Difference Register. J Paediatr Child Health 2022; 58(1): 122-8. doi: 10.1111\/jpc.15673.","DOI":"10.1111\/jpc.15673"},{"key":"168475","doi-asserted-by":"crossref","unstructured":"Piper S L, Dicke J M, Wall L B, Shen T S, Goldfarb C A. Prenatal detection of upper limb differences with obstetric ultrasound. J Hand Surg Am 2015; 40(7): 1310-7.e3. doi: 10.1016\/j.jhsa.2015.04.013.","DOI":"10.1016\/j.jhsa.2015.04.013"},{"key":"168476","doi-asserted-by":"crossref","unstructured":"Vandenbroucke J P, von Elm E, Altman D G, G\u00f8tzsche P C, Mulrow C D, Pocock S J, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med 2007; 147(8): W163-94. doi: 10.7326\/0003-4819-147-8-200710160-00010-w1.","DOI":"10.7326\/0003-4819-147-8-200710160-00010-w1"},{"key":"168477","unstructured":"Oslo University Hospital [Internet], Oslo [cited 2026 Jul 24]. Available from: https:\/\/www.oslo-universitetssykehus.no\/avdelinger\/ortopedisk-klinikk\/ortopedisk-avdeling-rikshospitalet\/nasjonal-behandlingstjeneste-for-dysmeli-i-overekstremiteten\/"},{"key":"168478","doi-asserted-by":"crossref","unstructured":"McCombe D, Wall L, Goldfarb C, H\u00fclsemann W, Sletten I N, Wilks D, et al. Congenital upper limb difference patient registries: characteristics, comparisons and recommendations. J Hand Surg Eur Vol 2025: 51(1): 111-18. doi: 10.1177\/17531934251348360.","DOI":"10.1177\/17531934251348360"},{"key":"168479","doi-asserted-by":"crossref","unstructured":"Goldfarb C A, Ezaki M, Wall L B, Lam W L, Oberg K C. The Oberg\u2013Manske-\u2013Tonkin (OMT) classification of congenital upper extremities: update for 2020. J Hand Surg Am 2020; 45(6): 542-7. doi: 10.1016\/j.jhsa.2020.01.002.","DOI":"10.1016\/j.jhsa.2020.01.002"},{"key":"168480","doi-asserted-by":"crossref","unstructured":"Oberg K C. Classification of congenital upper limb anomalies: towards improved communication, diagnosis, and discovery. J Hand Surg Eur Vol 2019; 44(1): 4-14. doi: 10.1177\/1753193418801280.","DOI":"10.1177\/1753193418801280"},{"key":"168481","unstructured":"Norwegian Directorate of Health [Internet], Oslo [cited 2026 Jul 24]. Available from: https:\/\/www.helsedirektoratet.no\/retningslinjer\/svangerskapsomsorgen\/konsultasjoner-i-svangerskapsomsorgen#gravide-med-et-normalt-svangerskap-bor-fa-tilbud-om-et-basisprogram-praktisk-informasjon"},{"key":"168482","unstructured":"Blix E. F\u00f8deinstitusjoner i Norge i Store medisinske leksikon [Internet], Oslo [cited 2026 July 24]. Available from: https:\/\/sml.snl.no\/f%C3%B8deinstitusjoner_i_Norge"},{"key":"168483","unstructured":"Norwegian University of Science and Technology [Internet], Trondheim [cited 2026 July 24]. Available from: https:\/\/www.ntnu.no\/videre\/ultralydutdanning"},{"key":"168484","doi-asserted-by":"crossref","unstructured":"Klungs\u00f8yr K, Nordtveit T I, Kaastad T S, Solberg S, Sletten I N, Vik A K. Epidemiology of limb reduction defects as registered in the Medical Birth Registry of Norway, 1970\u2013-2016: Population based study. PLoS One 2019; 14(7): e0219930. doi: 10.1371\/journal.pone.0219930.","DOI":"10.1371\/journal.pone.0219930"},{"key":"168485","doi-asserted-by":"crossref","unstructured":"Ardu\u00e7 A, van Dijk S J B, Ten Cate F J, van Doesburg M H M, Linskens I H, van Leeuwen E, et al. Phenotype-to-genotype description of prenatal suspected and postnatal discovered upper limb anomalies: a retrospective cohort study. Prenat Diagn 2025; 45(1): 3-14. doi: 10.1002\/pd.6714.","DOI":"10.1002\/pd.6714"},{"key":"168486","doi-asserted-by":"crossref","unstructured":"Forman M, Canizares M F, Bohn D, James M A, Samora J, Steinman S, et al. Association of radial longitudinal deficiency and thumb hypoplasia: an update using the CoULD Registry. J Bone Joint Surg Am 2020; 102(20): 1815-22. doi: 10.2106\/jbjs.20.00281.","DOI":"10.2106\/JBJS.20.00281"},{"key":"168487","doi-asserted-by":"crossref","unstructured":"Farr A, Wachutka E, Bettelheim D, Windsperger K, Farr S. 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J Hand Surg Am 2018; 43(4): 321-30. doi: 10.1016\/j.jhsa.2017.10.006.","DOI":"10.1016\/j.jhsa.2017.10.006"}],"container-title":["Acta Orthopaedica"],"original-title":[],"link":[{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46807\/55488","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46807\/55511","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46807\/55512","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/46807\/55488","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:58:52Z","timestamp":1789642732000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaorthop.org\/actao\/article\/view\/46807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":22,"URL":"https:\/\/doi.org\/10.2340\/17453674.2026.46807","relation":{},"ISSN":["1745-3682","1745-3674"],"issn-type":[{"value":"1745-3682","type":"electronic"},{"value":"1745-3674","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}