Clinodactyly

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Clinodactyly
Photograph of a left hand showing severe clinodactyly on the fifth finger.
The picture above illustrates a severe case of this condition.
Classification and external resources
Specialty medical genetics
ICD-10 Q74.0
ICD-9-CM 755.59
DiseasesDB 16756
MeSH C537090

Clinodactyly /ˈklnˌdæktɪli/ (from the Ancient Greek κλίνειν klínein meaning "to bend" and δάκτυλος dáktulos meaning "digit") is a medical term describing the curvature of a digit (a finger or toe) in the plane of the palm, most commonly the fifth finger (the "little finger") towards the adjacent fourth finger (the "ring finger").

It is a fairly common isolated anomaly which often goes unnoticed, but also occurs in combination with other abnormalities in certain genetic syndromes.[1]

Genetics[edit]

Clinodactyly is an autosomal dominant trait that has variable expressiveness and incomplete penetrance.[citation needed]

Clinodactyly can be passed through inheritance and presents as either an isolated anomaly or a component manifestation of a genetic syndrome[2]. Many syndromes are associated with clinodactyly, including:[citation needed], but the phenotype, by itself, is not a sensitive or specific diagnostic test for these syndromes (it is present in up to 18% of the normal population [3]).

When identified prenatally, in conjunction with other features of Down syndrome, for example during obstetric ultrasonography, it may be an indication for intrauterine sampling for fetal chromosome analysis [4].

Pathophysiology[edit]

Due to a developmental arrest there is an abnormal alignment of the joint surfaces at either interphalangeal joint causing angulation in the plane of the palm. The finger may be slightly bent or have a very prominent bend.[5]

Diagnosis[edit]

There is no consensus on what degree of angulation justifies a diagnosis, an incline between 15° and 30° is typical.[5] A similar-sounding term, camptodactyly, is a fixed flexion deformity of a digit.

Management[edit]

Treatment is only necessary if the degree of curvature is sufficient to cause disability or if it causes emotional distress. Splinting does not routinely correct the deformity. Surgical treatments are closing wedge osteotomy, opening wedge osteotomy, and reversed wedge osteotomy.[1] Radiographs of the fingers are useful in planning the surgical procedure. Severe clinodactyly may require soft tissue alterations to the digit such as release of skin, extensor tendon relocation, and collateral ligament advancement.[1]

Epidemiology[edit]

Minor degrees of curvature are common. Reports of incidence vary between 1% and 19.5%.[1]

References[edit]

  1. ^ a b c d Flatt, Adrian E (October 2005). "The troubles with pinkies". Baylor University Medical Center Proceedings. 18 (4): 341 to 344. PMC 1255945Freely accessible. PMID 16252026. 
  2. ^ Leung, Alexander K C; Kao, C Pion (December 2003). "Familial clinodactyly of the fifth finger". Journal of the National Medical Association. 95 (12): 1198–200. PMC 2594860Freely accessible. PMID 14717476. 
  3. ^ "Ermito,S., Dinatale,A., Carrara,S., Cavaliere,A., Imbruglia,L. and Recupero, S.Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography". J Prenat Med. 2009 Apr-Jun; 3(2): 18–22
  4. ^ "Ermito,S., Dinatale,A., Carrara,S., Cavaliere,A., Imbruglia,L. and Recupero, S. Prenatal diagnosis of limb abnormalities: role of fetal ultrasonography". J Prenat Med. 2009 Apr-Jun; 3(2): 18–22
  5. ^ a b Hersh, A. H.; DeMarinis, F.; Stecher, Robert M. (September 1953). "On the inheritance and development of clinodactyly". The American Journal of Human Genetics. 5 (3): 257 to 268. PMC 1716475Freely accessible. PMID 13080251. 

See also[edit]