Madelung Deformity

Madelung’s deformity is a congenital abnormality of the wrist caused by a growth disturbance that retards development of the ulnar and volar portions of the distal radial physis.

The eponym gives credit to Madelung, who described this entity. Carpus curvus, radius curvus, and progressive subluxation of the wrist, manus valgus, and manus furca are other terms used for this condition.

The primary deformity is bowing of the distal end of the radius, which in the most typical form curves in a volar diorection while the ulna continues to grow in a straight line. The distal ends of the radius and ulna are at different levels in the lateral plane. That of the ulna has maintained its original normal position, while that of the radius has curved down to a volar level. [Read more...]

Congenital Clasped Thumb

Congenital clasped thumb or thumb-clutched (or clasped) hand, is characterized by marked flexion of the first metacarpo-phalangeal joint and adduction into the palm.

The syndrome has been classified into following subtypes

  • Group I – Deficient extension only
  • Group II – Deficient extension combined with flexion contracture
  • Group III – Hypoplasia of the thumb associated with deficiencies of muscles and tendons
  • Group IV – The few cases not falling in the first three groups.

[Read more...]

Symphalangism-Failure Of Separation Of The Digits

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. [Read more...]

Polydactyly-Duplication of the Thumbs and Fingers

Preaxial Polydactyly

Preaxial polydactyly or extra thumbs are the common, occurring incidence of the deformity is 0.08 per 1000.

It rangesfrom a small fleshly webbing on the radial border of the hand to triplication. There are seven types of duplicate thumbs. [Read more...]

Congenital Longitudinal Deficiency of Hypoplastic Thumb

Congenital absence or hypoplasia of the thumb is often associated with congenital longitudinal deficiency of the radius. The spectrum of the defect varies from simple hypoplasia and miniature thumb to total absence of the thumb.

Hypoplastic Thumb

In the normal hand, the tip of the thumb reaches to the middle of the proximal phalanx of the index finger. When the thumb is shorter than this it can be classified as hypoplastic.

It is crucial to rule out associated abnormalities because often this malformation is a manifestation of a syndrome. [Read more...]

Triphalangeal Thumb

In the normal human hand the thumb has two phalanges; the triphalangeal thumb contains three palanages instead of the normal two.

The triphalangeal thumb may be an isolated anomaly without duplication.

It occurs in about one per 25,000 births, constituting the second most common type of thumb duplication. It is inherited as an autosomal dominant trait.

There is no sex predilection. In about 87 percent of the cases involvement is bilateral.

The thumb of the contralateral hand may be normal, absent, or duplicated.

Triphalangeal thumb may be part of a generalized syndrome . [Read more...]

Acrocephalosyndactylism or Apert Syndrome

Apert Syndrome First described as a syndrome by Apert in 1906 this anomaly primarily affects the head, hands, and feet and is characterized by synostosis of the cranial sutures and varying degrees of complex syndactyly of the hands and feet.

The condition is very rare, probably occurring in one in 200,000 births.

Its etiology is not known. It is, a genetic disturbance with a strong dominant inheritance; sporadic cases due to mutation do occur. [Read more...]

Congenital Dislocation of The Radial Head

Congenital dislocation of the radial head was described by McFarland. The direction of the displacement of the radial head may be anterior or posterior or lateral.

Condition is often unilateral.

The abnormality is usually not detected at birth, but is diagnosed later on in childhood when the elbow is examined following some minor injury.

Usually the elbows are asymptomatic. A complaint of stiffness may be reason of visit to physician in some cases. [Read more...]