China
Africa
Explore chapters and articles related to this topic
Congenital Hand
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Symbrachydactyly presents with a variety of findings including digital hypoplasia, aplasia or deficiency of the hand or forearm. The absent fingers are represented by “nubbins” with/without nail remnants [30]. The defect is believed to be mesodermal, which explains the remaining distal finger ectodermal structures [31].
Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Symbrachydactyly (sym – together) is characterised by short, stiff-webbed fingers creating a U-shaped cleft (see also ‘central deficiencies’). The cause is unknown but possibly related to a deficient blood supply, like Poland’s syndrome, to which it has an association. It occurs in 1 in 32,000 cases and is not inherited.
The wrist
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
True cleft hand presents with a V-shaped cleft in the centre of the hand which may be associated with the absence of one or more digits, a central transverse metacarpal (which widens the cleft with growth), syndactyly of digits bordering the cleft, and a narrow first web space (Figure 15.8d). It is often familial (autosomal dominant inheritance), may be unilateral or bilateral, and can be associated with ‘cleft feet’. Other anomalies, such as cleft lip, cleft palate and congenital heart disease, can be present. The condition differs from symbrachydactyly, previously known as ‘atypical cleft hand’, which is not heritable and not associated with other anomalies.
Long-term outcomes after phalangeal distraction lengthening in patients with constriction band syndrome
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Kousuke Iba, Kenichi Takashima, Megumi Hanaka, Atsushi Teramoto, Makoto Emori, Akira Saito, Hikaru Hayakawa, Toshihiko Yamashita
A previous study demonstrated that distraction lengthening of the metacarpals in patients with brachymetacarpia provided good post-operative outcomes. On the other hand, the study recommended that patients with brachymetacarpia should undergo bone lengthening when they are 10–15 years of age, with one of the reasons given being that as the epiphyseal plate is almost closed, the lengthening of the final shortening of the metacarpal can be appropriately estimated [2]. However, regarding impairment of pinch and grasp function due to short digits in congenital hand anomalies such as symbrachydactyly and constriction band syndrome, it is important for a patient to have function reconstructed as a young child. In this report, the patients with constriction band syndrome underwent phalangeal lengthening at 3 and 4 years of age, respectively, and adequate lengthening of the phalanges was obtained to allow pinch and grasp function, which was preserved more than 10 years. Thus, we believe that phalangeal lengthening should be performed as soon as possible when small digital bones grow to a suitable size for external fixation.