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Case 2.16
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
What is hypospadias? And why does it occur?This is a congenital condition, which may be familial, and is characterized by the triad of:a proximal meatus on the ventral surface,an incomplete prepuce which may be hooded, anda ventral curvature of the shaft.It may also be associated with:urethral valves,paraurethral sinuses, anda flattened glans.Proximal hypospadias is associated with:inguinal hernias, andanomalies of the genito urinary tract – including an undescended testis.Theories regarding its aetiology include:androgen receptor deficiency,an increase in the levels of environmental oestrogens, andgenetic anomalies in syndromic cases, such as chromosome 19 deletion in hand foot genital syndrome.
Usefulness of measurement of proximal phalanx length by using ultrasonography in newborn infants
Published in Journal of Obstetrics and Gynaecology, 2021
Natsumi Yamaguchi, Toshiyuki Yasui, Takashi Kaji, Eishi Sogawa, Atsuko Yoshida, Naoto Yonetani, Minoru Irahara
We focussed on proximal phalanx lengths in newborn infants and examined the possibility of using proximal phalanx length instead of digit length. The association of body height with proximal phalanx length seems to be stronger than the association of body height with digit length. The association of body weight with proximal phalanx length was also stronger than the association of body weight with digit length. Measurements of proximal phalanx lengths by USG indicate lengths of bones, and such measurements may be more reliable than measurements of digit lengths for assessment of possible gender differences in the associations of bone length with body height and body weight in newborn infants. Thus, measurement of proximal phalanx length may be useful. The possibility of measuring proximal phalanx lengths in foetuses would contribute to studies on exposure of the foetus to the hormonal environment. In mice, deregulation of Hoxd expression, which is related to limb and genital development, may alter the relative lengths of digits and affect growth of the genital bud (Kondo et al. 1997). It has been reported that hand-foot-genital syndrome in humans, which is characterised by mild defects in the digits and genitalis, is caused by a mutation within Hoxa (Mortlock and Innis 1997). Based on these results, Manning et al. (1998) suggested that patterns of digit growth may be related to gonadal function. Further study regarding the association of proximal phalanx length with the urogenital system may be needed.