Syndactyly of the 3rd and 4th digits

Case contributed by Dustin Roberts

Presentation

Bilateral hand pain and fused digits.

Patient Data

Age: 3 years
Gender: Male
X-ray

Left hand

Complete soft-tissue syndactyly of the middle and ring fingers in the left hand.

No osseous syndactyly or fusion is evident. Normal bone density.

Mild cortical irregularity of the tufts of the distal phalanges. Mild clinodactyly of the 5th digits.

X-ray

Right hand

Partial soft-tissue syndactyly of the middle and ring fingers in the right hand. No cortical abnormality present. Mild cortical irregularity of the tufts of the distal phalanges is seen with mild clinodactyly of the 5th digit.

Case Discussion

Syndactyly is the congenital fusion of soft tissue and/or osseous structures between two fingers. It can be present as an isolated anomaly or in association with polydactlyly, acrosyndactyly, clinodactyly, synostosis, or cleft hand. It can also be a feature in numerous congenital syndromes, including Apert’s syndrome, Poland’s syndrome, Pfeiffer syndrome, and Holt-Oram syndrome. Syndactyly and polydactyly (the presence of extraneous digits) represent the two most common congenital limb abnormalities.

The incidence is approximately 1 per 2500 to 5000 live births. It can be corrected surgically in almost all cases.

Bilateral syndactyly and syndactyly of the 3rd and 4th digits are both exceedingly rare. They are usually seen in association with complex disorders (e.g., Apert's syndrome, triploidy). Our patient has non-syndromic syndactyly, a sporadic occurrence without any associated anomalies.

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Case information

rID: 61208
Published: 5th Jul 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: David Geffen School of Medicine

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