Updated: 5/22/2021

Clinodactyly

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Images
https://upload.orthobullets.com/topic/6075/images/Clinical photo - neonet_moved.jpg
https://upload.orthobullets.com/topic/6075/images/type i.jpg
https://upload.orthobullets.com/topic/6075/images/delta phalanx.jpg
https://upload.orthobullets.com/topic/6075/images/Type III clinodactyly - sray - rad.co.uk_moved.jpg
  • summary
    • Clinodactyly is a congenital condition of the hand, often associated with Down's syndrome, that is characterized by the abnormal curvature of a digit in the radioulnar plane.
    • Diagnosis is made clinically.
    • Treatment is usually observation in the majority of cases. 
  • Epidemiology
    • Prevalence
      • found in 25% of children with Down's syndrome and 3% of general population
  • Etiology
    • Pathoanatomy
      • autosomal dominant inheritance
      • middle phalanx of small finger most commonly affected
  • Anatomy
    • Anatomy of ligaments of the fingers
  • Classification
    • Clinodactyly Classification
      Type I
      Minor angulation with normal length (most common)
      Type II
      Minor angulation with short length
      Type III
      Significant angulation and delta phalanx (c-shaped epiphysis and longitudinal bracketed diaphysis)
  • Presentation
    • Physical exam
      • function rarely significantly compromised
      • daily activities can be affected if deformity reaches 30-40 degrees
  • Imaging
    • Radiographs
      • C-shaped physis can result in a delta phalanx
  • Treatment
    • Nonoperative
      • observation
        • indications
          • favored in most cases
          • splinting is not indicated
    • Operative
      • phalanx opening wedge osteotomy +/- bone excision
        • indications
          • Type III (delta phalanx)
          • when deformity (delta phalanx) encroaches digit space of neighboring short digit
        • technique
          • excision of extra bone
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Private Note