Symbrachydactyly is a rare congenital upper limb anomaly which literally means 'fused short fingers' but can encompass a spectrum of clinical features. Classically, the middle digits of the hand are hypoplastic but with residual digital remnants - often described as 'nubbins' - nails or nail folds. Its features are difficult to attribute to a particular category within the IFSSH/Swanson scheme for congenital anomalies, but they have been considered in terms of atypical cleft hands (longitudinal failure of formation central deficiency), the transverse failure of formation and undergrowth.
Symbrachydactyly is sporadic in nature and has an incidence of 0.01% of all live births. It is thought to be due to a deficiency of mesoderm with a failure of induction of overlying ectoderm.
If the digits are simply short, intervention is rarely warranted as function is good. In more severe forms, techniques such as non-vascularized phalangeal transfer or free toe transplantation may be required.
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