Symphalangism is failure of separation of the digits in which there is fusion of one phalanx to another within the same digit.
This congenital malformation is in the general category of failure of differentiation of parts. It may occur as a simple isolated malformation or it may be associated with other deformities of the hands or feet, and it may also occur in numerous congenital syndromes such as Apert’s, Poland and Mobius syndrome.
Symphalangism is usually inherited as dominant trait.
It is most frequently found in Caucasians, occasionally in Orientals, and hardly ever in blacks.
Clinically the disorder is characterized by lack of motion of the affected joint in the finger. The skin overlying the fused articulation is smooth, and the transverse skin creases are absent.
This condition can be easily detected at birth.
One cannot, detect radiograpically at birth because of lack of ossification of the pahalges around the affected joint. With growth and maturation, when the bones ossify, there is a decrease in the articular width with eventual fusion.
Usually more than one finger is affected. When the proximal interphalangeal joint is affected, the digit is usually fixed in extension. At the level of the fused joint the soft tissues are narrowed.
The patient cannot make a fist and has difficulty in picking up small objects.
Treatment
Treatment is individualized.
Digits that are fixed in extension will be functionally improved by flexion osteotomy.
In symbrachydactyly, when there is an associated shortening of the fingers, one may gain relative length by recessing the interdigital webs into the spaces between the metacarpal heads.
Also, one may lengthen digits surgically.
The management of symphalangism with associated anomalies is complex. One should individualize the care; often it is difficult to improve function.
Popularity: 1% [?]
Related posts:
- Syndactyly of The Hand
- Congenital Clasped Thumb
- Congenital Radioulnar Synostosis
- Polydactyly-Duplication of the Thumbs and Fingers
- Congenital Longitudinal Deficiency of Hypoplastic Thumb
About Dr Arun Pal Singh
