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https://upload.orthobullets.com/topic/6075/images/Type III clinodactyly - sray - rad.co.uk_moved.jpg
Introduction
  • Congenital curvature of digit in radioulnar plane
    • found in 25% of children with Down's syndrome and 3% of general population
  • 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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