This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Patients with cleft hand present with a spectrum of clinical features:

  • commonly, absence of third ray structures:
    • middle finger absent
    • may be associated with hypoplasia or absence of the middle finger metacarpal
  • less frequently, absence of neighbouring digits:
    • typically, loss of three central rays leading to a two-fingered phenotype
    • if they are present, these bordering digits may exhibit relative hypertrophy compared to the contralateral side
    • possible syndactyly of digits either side of cleft
  • with worsening of the deficit, the radial side is increasingly affected and at its extreme, a single fifth ray (little finger) may be present
  • phalnageal abnormalities:
    • angulation
    • rotation
    • delta-shaped phalanges
    • longitudinally bracketed epiphyses
    • flexion contractures of proximal interphalangeal joints
  • metacarpal abnormalities:
    • fusion
    • two metacarpals may support one phalanx on one side of the cleft
    • bifid metacarpals supporting one phalanx
    • transverse or 'cross bones' at level of metacarpal; form a triangle attached at either end by a joint of synostosis to the border rays of the cleft
  • tendon abnormalities:
    • both intrinsic and extrinsic tendons present but may insert in an anomalous manner
    • intrinsic muscles of thumb particularly affected

In typical cleft hand, these findings are often bilateral. With split-hand split-foot, clefting can occur in the feet.


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.