Updated: 5/22/2021

Symphalangism

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  • Introduction
    • Congenital digital stiffness that comes in two forms
      • hereditary symphalangism
      • nonherediatry symphalangism
  • Epidemiology
    • Anatomic location
      • more common in ulnar digits
  • Etiology
    • Pathophysiology
      • failure of IP joint to differentiate during development
    • Genetics
      • inheritance pattern (hereditary type)
        • autosomal dominant
    • Associated conditions
      • syndactyly (nonhereditary type)
      • Apert's syndrome (nonhereditary type)
      • Poland's syndrome (nonhereditary type)
      • correctable hearing loss (hereditary type)
  • Presentation
    • Physical exam
      • inspection
        • absence of flexion and extension creases
      • motion
        • stiff digits
  • Imaging
    • Radiographs
      • IP joint space may appear narrow
  • Treatment
    • Nonoperative
      • observation
        • no indication for surgery in children
    • Operative
      • capsulectomy
        • outcome
          • limited success
      • IP joint arthroplasty
        • outcome
          • limited success
      • angular osteotomy
        • indications
          • rarely needed due to adequate digital function
      • arthrodesis
        • indications
          • may be considered during adolesence to improve function and cosmesis
          • rarely needed due to adequate digital function
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