Limb anomalies (VACTERL)

(Upper) (40–50%)

Major anomalies (24.7%)

• Accessory thumbs
• Congenital absence of hands and fingers, thumb
• Longitudinal reduction of radius including club hand
• Other upper limb defects

Minor anomalies (6.8%)

• Congenital deformity of fingers and hands
• Accessory fingers
• Fused or webbed fingers or polysyndactyly
• Congenital absence of parts of upper limbs

Why might these issues present to GPs in adulthood?

As for vertebral anomalies, pain and wear and tear may progress with age. Compensatory use of other joints may trigger osteoarthritis in these joints and it may of course develop in the anomalous joints.