Wingspread classification
Wingspread classification
A classification of anorectal malformations (ARMs) that was first elaborated in Wingspread, Wisconsin, in 1984. The Wingspread classification distinguishes between high (supralevator), intermediate (partially translevator) and low (translevator) ARMs in the male and female, with special groups established for cloacal and rare malformations. High ARMs are subdivided into anorectal agenesis with and without fistula, and rectal atresis; intermediate ARMs are classified as rectovestibular and rectovaginal fistula in the female, and as rectobulbar fistula in the male, as well as anal agenesis without fistula in both sexes; low ARMs are classified as anovestibular fistula in the female and, in both sexes, as anocutaneous fistula and anal stenosis.The Wingspread system was criticised, as the divisions into high, intermediate and low are often arbitrary, and because each group included defects with different therapeutic and prognostic implications. The Peña system (1995) is preferred.