857:(687 adults and 1259 larvae) were captured from a large wetland complex and evaluated for malformations. Among the 687 adults, 54 (7.9%) were malformed. Of these 54 adults, 46 (85%) had missing (ectrodactyly), extra (polyphalangy) or dwarfed digits (brachydactyly). Among the 1259 larvae, 102 were malformed, with 94 (92%) of the malformations involving ectrodactyly, polyphalangy, and brachydactyly. Results showed few differences in the frequency of malformations among life-history changes, suggesting that malformed larvae do not have substantially higher mortality than their adult conspecifics.
332:). The exact chromosomal defect in isolated cleft hand is not yet defined. However, the genetic causes of cleft hand related to syndromes have more clarity. The identified mutation for SHSF syndrome (split-hand/split-foot syndrome) a duplication on 10q24, and not a mutation of the tp63 gene as in families affected by EEC syndrome (ectrodactylyâectodermal dysplasiaâcleft syndrome). The p63 gene plays a critical role in the development of the apical ectodermal ridge (AER), this was found in mutant mice with dactylaplasia.
78:
140:
cleft hand appears as a V-shaped cleft situated in the centre of the hand. The digits at the borders of the cleft might be syndactilyzed, and one or more digits can be absent. In most types, the thumb, ring finger and little finger are the less affected parts of the hand. The incidence of cleft hand varies from 1 in 90,000 to 1 in 10,000 births depending on the used classification. Cleft hand can appear unilateral or bilateral, and can appear isolated or associated with a syndrome.
607:
50:
615:
2037:
725:
261:
between these morphogens, the involvement of modifier genes, and the presumed involvement of multiple gene or long-range regulatory elements in some cases of ectrodactyly. In the clinical setting these genetic characteristics can become problematic and making predictions of carrier status and severity of the disease impossible to predict.
148:(SHFM1 at 7q21-q22), SHFM2 (Xq26), SHFM3 (FBXW4/DACTYLIN at 10q24), SHFM4 (TP63 at 3q27), and SHFM5 (DLX1 and DLX 2 at 2q31). SHFM3 is unique in that it is caused by submicroscopic tandem chromosome duplications of FBXW4/DACTYLIN. SHFM3 is considered 'isolated' ectrodactyly and does not show a mutation of the tp63 gene.
642:
in 1575. Hartsink (1770) wrote the first report of true cleft hand. In 1896, the first operation of the cleft hand was performed by Doctor
Charles N. Dowed of New York City. However, the first certain description of what we know as a cleft hand as we know it today was described at the end of the 19th
585:
Ueba described a less complicated surgery. Transverse flaps are used to resurface the palm, the dorsal side of the transposed digit and the ulnar part of the first web space. A tendon graft is used to connect the common extensor tendons of the border digits of the cleft to prevent digital separation
572:
The goal of this procedure is to create a wide first web space and to minimise the cleft in the hand. The index digit will be transferred to the ulnar side of the cleft. Simultaneously a correction of index malrotation and deviation is performed. To minimise the cleft, it is necessary to fix together
462:
The social and stigmatising aspects of a cleft hand require more attention. The hand is a part of the body which is usually shown during communication. When this hand is obviously different and deformed, stigmatisation or rejection can occur. Sometimes, in families with cleft hand with good function,
139:
in which the development of the hand is disturbed. It is a type I failure of formation â longitudinal arrest. The central ray of the hand is affected and usually appears without proximal deficiencies of nerves, vessels, tendons, muscles and bones in contrast to the radial and ulnar deficiencies. The
844:
The
Department of Biological Sciences at the University of Alberta in Edmonton, Alberta performed a study to estimate deformity levels in wood frogs in areas of relatively low disturbance. After roughly 22,733 individuals were examined during field studies, it was found that only 49 wood frogs had
835:
Ectrodactyly is not only a genetic characteristic in humans, but can also occur in frogs and toads, mice, salamanders, cows, chickens, rabbits, marmosets, cats and dogs, and even West Indian manatees. The following examples are studies showing the natural occurrence of ectrodactyly in animals,
516:
When surgery is indicated, the choice of treatment is based on the classification. Table 4 shows the treatment of cleft hand divided into the classification of Manske and
Halikis. Techniques described by Ueba, Miura and Komada and the procedure of Snow-Littler are guidelines; since clinical and
507:
The timing of surgical interventions is debatable. Parents have to decide about their child in a very vulnerable time of their parenthood. Indications for early treatment are progressive deformities, such as syndactyly between index and thumb or transverse bones between the digital rays. Other
260:
A number of factors make the identification of the genetic defects underlying human ectrodactyly a complicated process: the limited number of families linked to each split hand/foot malformation (SHFM) locus, the large number of morphogens involved in limb development, the complex interactions
156:
Ectrodactyly can be caused by various changes to 7q. When 7q is altered by a deletion or a translocation, ectrodactyly can sometimes be associated with hearing loss. Ectrodactyly, or Split hand/split foot malformation (SHFM) type 1 is the only form of split hand/ malformation associated with
2174:
143:
Split hand/foot malformation (SHFM) is characterized by underdeveloped or absent central digital rays, clefts of hands and feet, and variable syndactyly of the remaining digits. SHFM is a heterogeneous condition caused by abnormalities at one of multiple loci, including
711:
Historically, a U-type cleft hand was also known as atypical cleft hand. The classification in which typical and atypical cleft hand are described was mostly used for clinical aspects and is shown in table 1. Nowadays, this "atypical cleft hand" is referred to as
271:
Ectrodactyly is frequently seen with other congenital anomalies. Syndromes in which ectrodactyly is associated with other abnormalities can occur when two or more genes are affected by a chromosomal rearrangement. Disorders associated with ectrodactyly include
362:
There are several classifications for cleft hand, but the most used classification is described by Manske and
Halikis see table 3. This classification is based on the first web space. The first web space is the space between the thumb and the index finger.
2167:
2098:
2083:
2160:
865:
Davis and Barry 1977 tested allele frequencies in domestic cats. Among the 265 cats observed, there were 101 males and 164 females. Only one cat was recorded to have the ectrodactyly abnormality, illustrating this rare disease.
1671:
1771:
Eaton, Brian R.; Eaves, Sara; Stevens, Cameron; Puchniak, Allison; Paszkowski, Cynthia A.; et al. (2004). "Deformity Levels in Wild
Populations of the Wood Frog (Rana sylvatica) in Three Ecoregions of Western Canada".
340:
Some studies have postulated that polydactyly, syndactyly and cleft hand have the same teratogenic mechanism. In vivo tests showed that limb anomalies were found alone or in combination with cleft hand when they were given
252:
and X-linked forms occur more rarely. Ectrodactyly can also be caused by a duplication on 10q24. Detailed studies of a number of mouse models for ectrodactyly have also revealed that a failure to maintain median
1458:
Naruse, Takuji; Takahara, Masatoshi; Takagi, Michiaki; Ogino, Toshihiko (2007). "Early
Morphological Changes Leading to Central Polydactyly, Syndactyly, and Central Deficiencies: An Experimental Study in Rats".
873:
dog. In another study, Carrig and co-workers also reported a series of 14 dogs with this abnormality proving that although ectrodactyly is an uncommon occurrence for dogs, it is not entirely unheard of.
128:). The hands and feet of people with ectrodactyly (ectrodactyls) are often described as "claw-like" and may include only the thumb and one finger (usually either the little finger, ring finger, or a
1342:
Shamseldin, Hanan E; Faden Maha A; Alashram Walid; Alkuraya Fowzan S (Nov 2011). "Identification of a novel DLX5 mutation in a family with autosomal recessive split hand and foot malformation".
594:
The release of the first webspace has the same principle as the Snow-Littler procedure. The difference is the closure of the first webspace; this is done by simple closure or closure with
273:
173:
2861:
2005:
Carrig, ColinB.; Wortman, JeffreyA.; Morris, EarlL.; Blevins, WilliamE.; Root, CharlesR.; Hanlon, GriseldaF.; Suter, PeterF. (1981). "Ectrodactyly (Split-hand deformity) in the dog".
936:
Durowaye, Mathew; Adegboye, Abdulrasheed; Mokuolu, Olugbenga
Ayodeji; Adeboye, Muhammed; Yahaya-Kongoila, Sefiyah; Adaje, Adeline; Adesiyun, Omotayo; Ernest, Samuel Kolade (2011).
312:
and cleft hand can occur within the same hand, therefore some investigators suggest that these entities occur from the same mechanism. This mechanism is not yet defined.
985:
Moerman, P.; Fryns, J.P. (1998). "Ectodermal dysplasia, RappâHodgkin type in a mother and severe ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC) in her child".
459:
of the condition. The function of a cleft hand is mostly not restricted, yet improving the function is one of the goals when the thumb or first webspace is absent.
987:
813:
2754:
281:
1107:
Kay, Simon P.; McCombe, David (2005). "Central hand deficiencies". In Green, David P.; Hotchkiss, Robert N.; Pederson, William C.; et al. (eds.).
2247:
2152:
836:
without the disease being reproduced and tested in a laboratory. In all three examples we see how rare the actual occurrence of ectrodactyly is.
1809:
Manson, Jeanne; Dourson, Michael L.; Smith, Carl C. (1977). "Effects of
Cytosine Arabinoside on In vivo and In vitro Mouse limb Development".
1116:
1035:
920:
180:
2695:
1283:
Scherer, Stephen; Cheung, J; MacDonald, JR; Osborne, LR; Nakabayashi, K; Herbrick, JA; Carson, AR; Parker-Katiraee, L; et al. (2003).
789:
1496:"Busulfan-induced central polydactyly, syndactyly and cleft hand or foot: A common mechanism of disruption leads to divergent phenotypes"
1000:
2113:
2056:
2047:
705:
Suppression progresses in a more ulnar direction; therefore in the monodactylous form the thumb is usually the last remaining digit
285:
665:
Atypical hand had a more severe manifestation in which there was varying absence of the central index, middle and ring finger rays
300:
The pathophysiology of cleft hand is thought to be a result of a wedge-shaped defect of the apical ectoderm of the limb bud (AER:
2649:
2368:
586:
during extension. The closure is simpler, but has cosmetic disadvantage because of the switch between palmar and dorsal skin.
222:
561:
There is no cleft or web space and the thumb is very deficient. This hand requires consideration of creating a radial digit
215:
2484:
2187:
229:
187:
2654:
2373:
2203:
2191:
1599:
Manske, Paul R.; Halikis, Mark N. (1995). "Surgical classification of central deficiency according to the thumb web".
1391:
1176:
745:
as an inspirational character who battles her disease and counsels another family who have children with ectrodactyly
2685:
803:
194:
2739:
853:
In a study performed by the
Department of Forestry and Natural Resources at Purdue University, approximately 2000
2659:
702:
Suppression progresses in a radial direction so that in the monodactylous form the most ulnar finger is preserved
1172:"Refinement of the deletion in 7q21.3 associated with split hand/foot malformation type 1 and Mondini dysplasia"
2594:
2237:
2124:
1246:
819:
634:
there is a man whose hands are crescent-shaped, and have only two fingers each, and his feet similarly formed.
517:
anatomical presentation within the types differ, the actual treatment is based on the individual abnormality.
2041:
2631:
2265:
2242:
1550:"Cleft hand: Classification, incidence and treatment: review of the literature and report of nineteen cases"
301:
254:
208:
2856:
1774:
236:
99:
2534:
2199:
758:
201:
1022:
Peterson-Falzone, Sally J.; Hardin-Jones, Mary A.; Karnell, Michael P.; McWilliams, Betty Jane (2001).
463:
operations for cosmetic aspects are considered marginal and the families choose not to have surgery.
320:
The cause of cleft hand lies, for what is known, partly in genetics. The inheritance of cleft hand is
2749:
1586:
Falliner AA., Analysis of anatomic variations in cleft hands, J Hand Surg Am. 2004 Nov;29(6):994-1001
1298:
783:
244:
A large number of human gene defects can cause ectrodactyly. The most common mode of inheritance is
606:
2567:
2183:
2102:
1927:
1637:
Manske, Paul R.; Goldfarb, Charles A. (2009). "Congenital
Failure of Formation of the Upper Limb".
1170:
Wieland, I.; Muschke, P; Jakubiczka, S; Volleth, M; Freigang, B; Wieacker, PF; et al. (2004).
325:
249:
136:
77:
31:
2429:
1834:
1791:
1494:
Naruse, Takuji; Takahara, Masatoshi; Takagi, Michiaki; Oberg, Kerby C.; Ogino, Toshihiko (2007).
1367:
321:
288:. More than 50 syndromes and associations involving ectrodactyly are distinguished in the London
245:
739:
Once a popular television anchor woman in Los Angeles, she has appeared in the television drama
1912:
Constitutional Disorders of the Skeleton in Dogs and Cats: Textbook of Small Animal Orthopedics
484:
Transverse bones (this will progress the deformity; growth of these bones will widen the cleft)
2764:
2744:
2135:
1944:
1892:
1826:
1748:
1703:
1654:
1616:
1569:
1517:
1476:
1418:
1359:
1324:
1289:
1265:
1203:
1149:
1112:
1031:
1004:
967:
916:
910:
66:
2811:
2806:
2727:
2719:
2639:
2603:
2411:
2363:
2320:
2014:
1985:
1975:
1936:
1882:
1874:
1818:
1783:
1695:
1646:
1608:
1561:
1507:
1468:
1408:
1400:
1351:
1314:
1306:
1255:
1193:
1185:
1141:
996:
957:
949:
753:
713:
639:
329:
71:
869:
According to M.P. Ferreira, a case of ectrodactyly was found in a two-month-old male mixed
2827:
2562:
2392:
2358:
2311:
1940:
1051:
117:
1925:
Davis, Brian; Davis, Barry (1977). "Allele frequencies in a cat population in Budapest".
809:
1962:
Ferreira, M.P.; Alievi, M.M.; Beck, C.A.C.; Voll, J.; Muccillo, M.S.; Gomes, C. (2007).
1302:
455:
The treatment of cleft hand is usually invasive and can differ each time because of the
2690:
2621:
2585:
2557:
2479:
2383:
2257:
2018:
1887:
1862:
1413:
1386:
1319:
1284:
1198:
1171:
1024:
962:
937:
888:
277:
2107:
1612:
577:
which used to border the cleft. Through repositioning flaps, the wound can be closed.
257:(AER) signalling can be the main pathogenic mechanism in triggering this abnormality.
2850:
2700:
2644:
2611:
2494:
2315:
1565:
1512:
1495:
456:
1980:
1963:
1838:
1795:
1371:
662:
Typical hand was manifest in the complete or incomplete absence of the middle finger
2782:
2675:
2517:
2275:
2270:
883:
823:
752:: known publicly as Lobster Boy and family, famous side show acts, featured on the
749:
481:
Deforming syndactyly (mostly between digits of unequal length like index and thumb)
1355:
30:
This article is about the congenital disorder. For the neurological syndrome, see
2129:
1721:
1132:
Upton, Joseph; Taghinia, Amir H. (2010). "Correction of the Typical Cleft Hand".
1111:(5th ed.). Philadelphia: Elsevier/ Churchill Livingstone. pp. 1404â15.
2705:
2472:
2463:
2348:
2280:
854:
775:
736:
574:
553:
Mobility and/or position of the thumb of ulnar digit to promote pinch and grasp
545:
Transposition of the index metacarpal with reconstruction of the thumb webspace
444:
Thumb elements suppressed, ulnar rays remain, thumb web space no longer present
305:
2140:
1699:
1472:
1145:
49:
2680:
2616:
2529:
2523:
2499:
2467:
2434:
2403:
2353:
2325:
2092:
1650:
797:
595:
309:
289:
129:
58:
1739:
Farrell HB (1984). "The two-toed Wadoma--familial ectrodactyly in Zimbabwe".
2787:
2732:
2539:
2424:
2417:
2398:
2330:
2294:
1310:
1189:
1056:
1001:
10.1002/(SICI)1096-8628(19960614)63:3<479::AID-AJMG12>3.0.CO;2-J
614:
346:
1896:
1878:
1861:
Williams, Rod N; Bos, David H; Gopurenko, David; DeWoody, J Andrew (2008).
1707:
1686:
Jones, Neil F; Kono, Michiyuki (2004). "Cleft hands with six metacarpals".
1658:
1573:
1521:
1480:
1363:
1328:
1269:
1207:
1153:
971:
638:
The first modern reference to what might be considered a cleft hand was by
280:
and Limb-mammary (LMS) syndrome, Ectrodactyly-Cleft Palate (ECP) syndrome,
2036:
1752:
1620:
1422:
1008:
116: 'finger') involves the deficiency or absence of one or more central
17:
2229:
2225:
2207:
1948:
1830:
1549:
1404:
1260:
1241:
770:
741:
953:
2797:
2455:
1990:
1822:
870:
631:
366:
Table 3: Classification for cleft hand described by Manske and Halikis
342:
2075:
724:
610:
Ectrodactyly in all extremities; only eight total digits present, 1870
508:
surgical interventions are less urgent and can wait for 1 or 2 years.
471:
Surgical treatment of the cleft hand is based on several indications:
2087:
779:
766:
728:
520:
Table 4: Treatment based on the classification of Manske and Halikis
328:
of 70%. Cleft hand can be a spontaneous mutation during pregnancy (
1787:
938:"Familial Ectrodactyly Syndrome in a Nigerian Child: A Case Report"
723:
613:
605:
145:
1914:. Ithaca, New York: International Veterinary Information Service.
2340:
2118:
2060:
2051:
622:
Literature shows that cleft hand is described centuries ago. In
265:
2156:
891:, a main gene responsible for body symmetry during development.
433:
Index ray suppressed, thumb web space is merged with the cleft
2773:
2303:
2216:
284:, Ectrodactyly-Fibular Aplasia/Hypoplasia (EFA) syndrome, and
282:
Ectrodactyly-Ectodermal Dysplasia-Macular Dystrophy syndrome
792:
showing his right profile and right hand with ectrodactyly
422:
Thumb and index rays syndactylized, web space obliterated
618:
Monodactyly of both hands; only two fingers present, 1897
274:
Ectrodactyly-Ectodermal Dysplasia-Clefting (EEC) syndrome
345:. These anomalies take place in humans around day 41 of
27:
Malformation of the central digit(s) of the hand or foot
1968:
Arquivo Brasileiro de Medicina VeterinĂĄria e Zootecnia
800:, a Korean pianist with only two fingers on each hand.
537:
Reconstruction of the transverse metacarpal ligament
2065:
1242:"Pathogenesis of split-hand/split-foot malformation"
650:
522:
368:
132:
of the two) with similar abnormalities of the feet.
2820:
2796:
2772:
2763:
2718:
2668:
2630:
2602:
2593:
2584:
2550:
2510:
2454:
2447:
2382:
2339:
2302:
2293:
2256:
2224:
2215:
2198:
2069:
65:
42:
1023:
915:. Oxford: Oxford University Press. p. 197.
174:Ectrodactylyâectodermal dysplasiaâcleft syndrome
628:
2862:Congenital disorders of musculoskeletal system
1285:"Human Chromosome 7: DNA Sequence and Biology"
2168:
1438:
1436:
1434:
1432:
8:
822:, British pro tennis player, former #149 in
1856:
1854:
1852:
1850:
1848:
1632:
1630:
1447:. American Society for Surgery of the Hand.
1385:Winter, R.M.; Baraitser, M. (August 1987).
988:American Journal of Medical Genetics Part A
2769:
2599:
2590:
2451:
2299:
2221:
2212:
2175:
2161:
2153:
2066:
76:
48:
39:
1989:
1979:
1886:
1594:
1592:
1543:
1541:
1539:
1537:
1535:
1533:
1531:
1511:
1500:Development, Growth & Differentiation
1412:
1318:
1259:
1197:
1165:
1163:
961:
120:of the hand or foot and is also known as
1863:"Amphibian malformations and inbreeding"
1766:
1764:
1762:
1681:
1679:
1235:
1233:
1231:
1229:
1227:
1225:
1223:
1221:
1219:
1217:
164:
901:
657:Atypical cleft hand (symbrachydactyly)
223:Ectrodactyly/mandibulofacial dysostosis
1964:"Ectrodactilia em cĂŁo: relato de caso"
1102:
1100:
1098:
1096:
1094:
1092:
1090:
1088:
1086:
1084:
216:Ectrodactyly and cleft palate syndrome
1941:10.1093/oxfordjournals.jhered.a108768
1554:The Journal of Bone and Joint Surgery
1082:
1080:
1078:
1076:
1074:
1072:
1070:
1068:
1066:
1064:
909:Giele, Henk; Cassell, Oliver (2008).
276:, which is closely correlated to the
181:Split-Hand-Foot Malformation Syndrome
7:
2696:Greig cephalopolysyndactyly syndrome
716:and is not a subtype of cleft hand.
2057:Online Mendelian Inheritance in Man
2048:Online Mendelian Inheritance in Man
1387:"The London Dysmorphology Database"
626:(426 A.D.), St. Augustine remarks:
135:It is a substantial rare form of a
61:on the hand of a one-year-old child
2186:malformations and deformations of
2019:10.1111/j.1740-8261.1981.tb01363.x
1240:Pascal, H.G.; et al. (2003).
912:Plastic and Reconstructive Surgery
411:Thumb web space severely narrowed
268:was found to be involved in SHFM.
230:Ectrodactyly and macular dystrophy
122:split hand/split foot malformation
25:
2035:
1672:City of God, Book XVI, Chapter 8
1566:10.2106/00004623-196446080-00006
1513:10.1111/j.1440-169X.2007.00949.x
503:Timing of surgical interventions
400:Thumb web space mildly narrowed
109: 'miscarriage' and
2369:Congenital patellar dislocation
2248:WallisâZieffâGoldblatt syndrome
1981:10.1590/S0102-09352007000400015
1722:"Medical Mystery: Ectrodactyly"
248:with reduced penetrance, while
1109:Green's Operative Hand Surgery
1:
1613:10.1016/S0363-5023(05)80293-X
1443:Katarincic, Julia A. (2003).
1356:10.1136/jmedgenet-2011-100556
389:Thumb web space not narrowed
264:In 2011, a novel mutation in
845:the ectrodactyly deformity.
681:One limb involved (no feet)
512:Classification and treatment
157:sensorineural hearing loss.
2655:Oto-palato-digital syndrome
2650:HallermannâStreiff syndrome
2374:Congenital knee dislocation
2192:musculoskeletal abnormality
1688:The Journal of Hand Surgery
1601:The Journal of Hand Surgery
1461:The Journal of Hand Surgery
1392:Journal of Medical Genetics
1344:Journal of Medical Genetics
1177:Journal of Medical Genetics
1134:The Journal of Hand Surgery
1052:Congenital Hand Deformities
2878:
2686:Craniodiaphyseal dysplasia
1700:10.1016/j.jhsa.2004.04.002
1473:10.1016/j.jhsa.2007.06.017
1146:10.1016/j.jhsa.2009.12.021
814:2020 US Open Quad Champion
678:One to four limbs involved
195:Cornelia de Lange syndrome
29:
2660:Treacher Collins syndrome
2511:reduction deficits / limb
1651:10.1016/j.hcl.2008.10.005
1548:Barsky, Arthur J (1964).
56:
47:
2485:CenaniâLenz syndactylism
2238:Cleidocranial dysostosis
1247:Human Molecular Genetics
731:people with ectrodactyly
286:Ectrodactyly-Polydactyly
2632:Craniofacial dysostosis
1311:10.1126/science.1083423
1190:10.1136/jmg.2003.010587
806:, freak show performer.
487:Narrowed first webspace
302:apical ectodermal ridge
255:apical ectodermal ridge
209:Focal dermal hypoplasia
188:SilverâRussell syndrome
2188:musculoskeletal system
1879:10.1098/rsbl.2008.0233
1775:Journal of Herpetology
732:
636:
619:
611:
237:Buttien-Fryns syndrome
2740:KlippelâFeil syndrome
748:Grady Stiles Sr. and
727:
617:
609:
408:Severely narrowed web
2750:Spina bifida occulta
2266:Madelung's deformity
2243:Sprengel's deformity
2044:at Wikimedia Commons
2007:Veterinary Radiology
1910:Jezyk, P.F. (1985).
1405:10.1136/jmg.24.8.509
942:Oman Medical Journal
784:World Chess Champion
494:Aesthetical aspects
2568:RAPADILINO syndrome
1928:Journal of Heredity
1728:. January 27, 2007.
1303:2003Sci...300..767S
1026:Cleft Palate Speech
954:10.5001/omj.2011.67
397:Mildly narrowed web
326:variable penetrance
250:autosomal recessive
137:congenital disorder
32:split hand syndrome
2430:Rocker bottom foot
1823:10.1007/BF02615104
1261:10.1093/hmg/ddg090
769:tribe in northern
733:
694:Autosomal dominant
654:Typical cleft hand
620:
612:
498:Reducing deformity
475:Improving function
322:autosomal dominant
246:autosomal dominant
202:Acrorenal syndrome
2844:
2843:
2840:
2839:
2836:
2835:
2765:Thoracic skeleton
2745:Spondylolisthesis
2714:
2713:
2580:
2579:
2576:
2575:
2443:
2442:
2289:
2288:
2150:
2149:
2040:Media related to
1297:(5620): 767â772.
1118:978-0-443-06626-9
1037:978-0-8151-3153-3
922:978-0-19-263222-7
709:
708:
565:
564:
448:
447:
419:Syndactylized web
242:
241:
85:
84:
57:Ectrodactyly and
37:Medical condition
16:(Redirected from
2869:
2812:Pectus carinatum
2807:Pectus excavatum
2770:
2728:Spinal curvature
2720:Vertebral column
2640:Crouzon syndrome
2604:Craniosynostosis
2600:
2591:
2456:fingers and toes
2452:
2364:Discoid meniscus
2321:Upington disease
2300:
2222:
2213:
2177:
2170:
2163:
2154:
2067:
2039:
2023:
2022:
2002:
1996:
1995:
1993:
1983:
1959:
1953:
1952:
1922:
1916:
1915:
1907:
1901:
1900:
1890:
1858:
1843:
1842:
1806:
1800:
1799:
1768:
1757:
1756:
1736:
1730:
1729:
1718:
1712:
1711:
1683:
1674:
1669:
1663:
1662:
1634:
1625:
1624:
1596:
1587:
1584:
1578:
1577:
1545:
1526:
1525:
1515:
1491:
1485:
1484:
1455:
1449:
1448:
1440:
1427:
1426:
1416:
1382:
1376:
1375:
1339:
1333:
1332:
1322:
1280:
1274:
1273:
1263:
1237:
1212:
1211:
1201:
1167:
1158:
1157:
1129:
1123:
1122:
1104:
1059:
1048:
1042:
1041:
1029:
1019:
1013:
1012:
982:
976:
975:
965:
933:
927:
926:
906:
750:Grady Stiles Jr.
714:symbrachydactyly
689:Lower incidence
686:Higher incidence
651:
647:Symbrachydactyly
632:Hippo-Diarrhytus
590:Miura and Komada
523:
378:Characteristics
369:
330:de novo mutation
165:
81:
80:
72:Medical genetics
52:
40:
21:
2877:
2876:
2872:
2871:
2870:
2868:
2867:
2866:
2847:
2846:
2845:
2832:
2828:Poland syndrome
2816:
2792:
2759:
2710:
2664:
2626:
2572:
2563:Larsen syndrome
2551:multiple joints
2546:
2506:
2439:
2378:
2359:Genu recurvatum
2335:
2312:Hip dislocation
2285:
2252:
2202:
2194:
2181:
2151:
2146:
2145:
2078:
2032:
2027:
2026:
2004:
2003:
1999:
1961:
1960:
1956:
1924:
1923:
1919:
1909:
1908:
1904:
1867:Biology Letters
1860:
1859:
1846:
1808:
1807:
1803:
1770:
1769:
1760:
1738:
1737:
1733:
1720:
1719:
1715:
1685:
1684:
1677:
1670:
1666:
1636:
1635:
1628:
1598:
1597:
1590:
1585:
1581:
1547:
1546:
1529:
1493:
1492:
1488:
1457:
1456:
1452:
1442:
1441:
1430:
1384:
1383:
1379:
1341:
1340:
1336:
1282:
1281:
1277:
1239:
1238:
1215:
1169:
1168:
1161:
1131:
1130:
1126:
1119:
1106:
1105:
1062:
1049:
1045:
1038:
1021:
1020:
1016:
984:
983:
979:
935:
934:
930:
923:
908:
907:
903:
898:
880:
863:
851:
842:
833:
820:Francesca Jones
722:
673:U-shaped cleft
649:
604:
592:
583:
570:
514:
505:
469:
453:
360:
355:
338:
318:
298:
296:Pathophysiology
163:
154:
75:
38:
35:
28:
23:
22:
15:
12:
11:
5:
2875:
2873:
2865:
2864:
2859:
2849:
2848:
2842:
2841:
2838:
2837:
2834:
2833:
2831:
2830:
2824:
2822:
2818:
2817:
2815:
2814:
2809:
2803:
2801:
2794:
2793:
2791:
2790:
2785:
2779:
2777:
2767:
2761:
2760:
2758:
2757:
2752:
2747:
2742:
2737:
2736:
2735:
2724:
2722:
2716:
2715:
2712:
2711:
2709:
2708:
2703:
2698:
2693:
2691:Dolichocephaly
2688:
2683:
2678:
2672:
2670:
2666:
2665:
2663:
2662:
2657:
2652:
2647:
2642:
2636:
2634:
2628:
2627:
2625:
2624:
2622:Trigonocephaly
2619:
2614:
2608:
2606:
2597:
2595:Skull and face
2588:
2582:
2581:
2578:
2577:
2574:
2573:
2571:
2570:
2565:
2560:
2558:Arthrogryposis
2554:
2552:
2548:
2547:
2545:
2544:
2543:
2542:
2537:
2532:
2520:
2514:
2512:
2508:
2507:
2505:
2504:
2503:
2502:
2492:
2487:
2482:
2480:Arachnodactyly
2477:
2476:
2475:
2460:
2458:
2449:
2445:
2444:
2441:
2440:
2438:
2437:
2432:
2427:
2422:
2421:
2420:
2408:
2407:
2406:
2401:
2388:
2386:
2384:foot deformity
2380:
2379:
2377:
2376:
2371:
2366:
2361:
2356:
2351:
2345:
2343:
2337:
2336:
2334:
2333:
2328:
2323:
2318:
2308:
2306:
2297:
2291:
2290:
2287:
2286:
2284:
2283:
2278:
2273:
2268:
2262:
2260:
2258:hand deformity
2254:
2253:
2251:
2250:
2245:
2240:
2234:
2232:
2219:
2210:
2196:
2195:
2182:
2180:
2179:
2172:
2165:
2157:
2148:
2147:
2144:
2143:
2132:
2121:
2110:
2095:
2079:
2074:
2073:
2071:
2070:Classification
2064:
2063:
2054:
2045:
2031:
2030:External links
2028:
2025:
2024:
1997:
1954:
1917:
1902:
1844:
1817:(7): 434â442.
1801:
1788:10.1670/95-03N
1782:(2): 283â287.
1758:
1741:S. Afr. Med. J
1731:
1713:
1675:
1664:
1626:
1588:
1579:
1527:
1486:
1450:
1428:
1399:(8): 509â510.
1377:
1334:
1275:
1254:(1): R51âR60.
1213:
1159:
1124:
1117:
1060:
1043:
1036:
1014:
977:
928:
921:
900:
899:
897:
894:
893:
892:
889:Sonic hedgehog
886:
879:
876:
862:
859:
850:
847:
841:
838:
832:
829:
828:
827:
817:
807:
804:Black Scorpion
801:
795:
794:
793:
782:chess player,
773:
763:
756:reality show,
746:
721:
718:
707:
706:
703:
699:
698:
695:
691:
690:
687:
683:
682:
679:
675:
674:
671:
670:V-shaped cleft
667:
666:
663:
659:
658:
655:
648:
645:
603:
600:
591:
588:
582:
579:
569:
566:
563:
562:
559:
555:
554:
551:
547:
546:
543:
539:
538:
535:
531:
530:
527:
513:
510:
504:
501:
500:
499:
492:
491:
488:
485:
482:
479:
476:
468:
465:
452:
449:
446:
445:
442:
439:
435:
434:
431:
428:
424:
423:
420:
417:
413:
412:
409:
406:
402:
401:
398:
395:
391:
390:
387:
384:
380:
379:
376:
373:
359:
358:Classification
356:
354:
351:
337:
334:
317:
314:
297:
294:
278:ADULT syndrome
240:
239:
233:
232:
226:
225:
219:
218:
212:
211:
205:
204:
198:
197:
191:
190:
184:
183:
177:
176:
170:
169:
162:
159:
153:
150:
83:
82:
69:
63:
62:
54:
53:
45:
44:
36:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
2874:
2863:
2860:
2858:
2857:Rare diseases
2855:
2854:
2852:
2829:
2826:
2825:
2823:
2819:
2813:
2810:
2808:
2805:
2804:
2802:
2799:
2795:
2789:
2786:
2784:
2781:
2780:
2778:
2775:
2771:
2768:
2766:
2762:
2756:
2755:Sacralization
2753:
2751:
2748:
2746:
2743:
2741:
2738:
2734:
2731:
2730:
2729:
2726:
2725:
2723:
2721:
2717:
2707:
2704:
2702:
2701:Plagiocephaly
2699:
2697:
2694:
2692:
2689:
2687:
2684:
2682:
2679:
2677:
2674:
2673:
2671:
2667:
2661:
2658:
2656:
2653:
2651:
2648:
2646:
2645:Hypertelorism
2643:
2641:
2638:
2637:
2635:
2633:
2629:
2623:
2620:
2618:
2615:
2613:
2612:Scaphocephaly
2610:
2609:
2607:
2605:
2601:
2598:
2596:
2592:
2589:
2587:
2583:
2569:
2566:
2564:
2561:
2559:
2556:
2555:
2553:
2549:
2541:
2538:
2536:
2533:
2531:
2528:
2527:
2526:
2525:
2521:
2519:
2516:
2515:
2513:
2509:
2501:
2498:
2497:
2496:
2495:Brachydactyly
2493:
2491:
2488:
2486:
2483:
2481:
2478:
2474:
2471:
2470:
2469:
2465:
2462:
2461:
2459:
2457:
2453:
2450:
2448:Either / both
2446:
2436:
2433:
2431:
2428:
2426:
2423:
2419:
2416:
2415:
2414:
2413:
2409:
2405:
2402:
2400:
2397:
2396:
2395:
2394:
2390:
2389:
2387:
2385:
2381:
2375:
2372:
2370:
2367:
2365:
2362:
2360:
2357:
2355:
2352:
2350:
2347:
2346:
2344:
2342:
2338:
2332:
2329:
2327:
2324:
2322:
2319:
2317:
2316:Hip dysplasia
2313:
2310:
2309:
2307:
2305:
2301:
2298:
2296:
2292:
2282:
2279:
2277:
2274:
2272:
2269:
2267:
2264:
2263:
2261:
2259:
2255:
2249:
2246:
2244:
2241:
2239:
2236:
2235:
2233:
2231:
2227:
2223:
2220:
2218:
2214:
2211:
2209:
2205:
2201:
2197:
2193:
2189:
2185:
2178:
2173:
2171:
2166:
2164:
2159:
2158:
2155:
2142:
2138:
2137:
2133:
2131:
2127:
2126:
2122:
2120:
2116:
2115:
2111:
2109:
2105:
2104:
2100:
2096:
2094:
2090:
2089:
2085:
2081:
2080:
2077:
2072:
2068:
2062:
2058:
2055:
2053:
2049:
2046:
2043:
2038:
2034:
2033:
2029:
2020:
2016:
2013:(3): 123â44.
2012:
2008:
2001:
1998:
1992:
1987:
1982:
1977:
1973:
1969:
1965:
1958:
1955:
1950:
1946:
1942:
1938:
1934:
1930:
1929:
1921:
1918:
1913:
1906:
1903:
1898:
1894:
1889:
1884:
1880:
1876:
1873:(5): 549â52.
1872:
1868:
1864:
1857:
1855:
1853:
1851:
1849:
1845:
1840:
1836:
1832:
1828:
1824:
1820:
1816:
1812:
1805:
1802:
1797:
1793:
1789:
1785:
1781:
1777:
1776:
1767:
1765:
1763:
1759:
1754:
1750:
1747:(13): 531â3.
1746:
1742:
1735:
1732:
1727:
1723:
1717:
1714:
1709:
1705:
1701:
1697:
1693:
1689:
1682:
1680:
1676:
1673:
1668:
1665:
1660:
1656:
1652:
1648:
1645:(2): 157â70.
1644:
1640:
1633:
1631:
1627:
1622:
1618:
1614:
1610:
1607:(4): 687â97.
1606:
1602:
1595:
1593:
1589:
1583:
1580:
1575:
1571:
1567:
1563:
1559:
1555:
1551:
1544:
1542:
1540:
1538:
1536:
1534:
1532:
1528:
1523:
1519:
1514:
1509:
1506:(6): 533â41.
1505:
1501:
1497:
1490:
1487:
1482:
1478:
1474:
1470:
1467:(9): 1413â7.
1466:
1462:
1454:
1451:
1446:
1439:
1437:
1435:
1433:
1429:
1424:
1420:
1415:
1410:
1406:
1402:
1398:
1394:
1393:
1388:
1381:
1378:
1373:
1369:
1365:
1361:
1357:
1353:
1349:
1345:
1338:
1335:
1330:
1326:
1321:
1316:
1312:
1308:
1304:
1300:
1296:
1292:
1291:
1286:
1279:
1276:
1271:
1267:
1262:
1257:
1253:
1249:
1248:
1243:
1236:
1234:
1232:
1230:
1228:
1226:
1224:
1222:
1220:
1218:
1214:
1209:
1205:
1200:
1195:
1191:
1187:
1183:
1179:
1178:
1173:
1166:
1164:
1160:
1155:
1151:
1147:
1143:
1139:
1135:
1128:
1125:
1120:
1114:
1110:
1103:
1101:
1099:
1097:
1095:
1093:
1091:
1089:
1087:
1085:
1083:
1081:
1079:
1077:
1075:
1073:
1071:
1069:
1067:
1065:
1061:
1058:
1054:
1053:
1047:
1044:
1039:
1033:
1028:
1027:
1018:
1015:
1010:
1006:
1002:
998:
995:(3): 479â81.
994:
990:
989:
981:
978:
973:
969:
964:
959:
955:
951:
947:
943:
939:
932:
929:
924:
918:
914:
913:
905:
902:
895:
890:
887:
885:
882:
881:
877:
875:
872:
867:
861:Cats and dogs
860:
858:
856:
848:
846:
839:
837:
830:
825:
821:
818:
815:
811:
808:
805:
802:
799:
796:
791:
788:
787:
785:
781:
777:
774:
772:
768:
764:
761:
760:
755:
751:
747:
744:
743:
738:
735:
734:
730:
726:
720:Notable cases
719:
717:
715:
704:
701:
700:
696:
693:
692:
688:
685:
684:
680:
677:
676:
672:
669:
668:
664:
661:
660:
656:
653:
652:
646:
644:
641:
640:Ambroise Paré
635:
633:
627:
625:
616:
608:
601:
599:
597:
589:
587:
580:
578:
576:
567:
560:
557:
556:
552:
549:
548:
544:
541:
540:
536:
533:
532:
528:
525:
524:
521:
518:
511:
509:
502:
497:
496:
495:
489:
486:
483:
480:
477:
474:
473:
472:
466:
464:
460:
458:
457:heterogeneity
450:
443:
440:
437:
436:
432:
429:
426:
425:
421:
418:
415:
414:
410:
407:
404:
403:
399:
396:
393:
392:
388:
385:
382:
381:
377:
374:
371:
370:
367:
364:
357:
352:
350:
348:
344:
335:
333:
331:
327:
323:
315:
313:
311:
307:
303:
295:
293:
291:
290:Dysmorphology
287:
283:
279:
275:
269:
267:
262:
258:
256:
251:
247:
238:
235:
234:
231:
228:
227:
224:
221:
220:
217:
214:
213:
210:
207:
206:
203:
200:
199:
196:
193:
192:
189:
186:
185:
182:
179:
178:
175:
172:
171:
167:
166:
160:
158:
151:
149:
147:
141:
138:
133:
131:
127:
123:
119:
115:
111:
108:
104:
101:
100:Ancient Greek
97:
93:
89:
79:
73:
70:
68:
64:
60:
55:
51:
46:
41:
33:
19:
2676:Macrocephaly
2522:
2518:Acheiropodia
2490:Ectrodactyly
2489:
2410:
2391:
2276:Oligodactyly
2271:Clinodactyly
2200:Appendicular
2134:
2123:
2112:
2097:
2082:
2042:Ectrodactyly
2010:
2006:
2000:
1974:(4): 910â3.
1971:
1967:
1957:
1935:(1): 31â34.
1932:
1926:
1920:
1911:
1905:
1870:
1866:
1814:
1810:
1804:
1779:
1773:
1744:
1740:
1734:
1725:
1716:
1694:(4): 720â6.
1691:
1687:
1667:
1642:
1639:Hand Clinics
1638:
1604:
1600:
1582:
1557:
1553:
1503:
1499:
1489:
1464:
1460:
1453:
1444:
1396:
1390:
1380:
1350:(1): 16â20.
1347:
1343:
1337:
1294:
1288:
1278:
1251:
1245:
1181:
1175:
1140:(3): 480â5.
1137:
1133:
1127:
1108:
1050:
1046:
1025:
1017:
992:
986:
980:
948:(4): 275â8.
945:
941:
931:
911:
904:
884:Oligodactyly
868:
864:
852:
843:
834:
824:WTA rankings
810:Sam Schröder
757:
740:
710:
637:
629:
623:
621:
593:
584:
571:
568:Snow-Littler
519:
515:
506:
493:
478:Absent thumb
470:
461:
454:
365:
361:
339:
319:
299:
270:
263:
259:
243:
155:
152:Presentation
142:
134:
125:
121:
113:
110:
106:
103:
95:
91:
88:Ectrodactyly
87:
86:
43:Ectrodactyly
2706:Saddle nose
2473:Webbed toes
2464:Polydactyly
2349:Genu valgum
2281:Polydactyly
1991:10183/76981
1560:: 1707â20.
855:salamanders
849:Salamanders
776:Mikhail Tal
737:Bree Walker
624:City of God
575:metacarpals
467:Indications
375:Description
306:Polydactyly
2851:Categories
2681:Platybasia
2617:Oxycephaly
2530:Phocomelia
2524:Ectromelia
2500:Stub thumb
2468:Syndactyly
2435:Hammer toe
2404:Pigeon toe
2354:Genu varum
2326:Coxa valga
2184:Congenital
2136:DiseasesDB
1445:Cleft Hand
1184:(5): e54.
896:References
798:Lee Hee-ah
790:Photograph
596:Z-plasties
529:Treatment
441:Absent web
430:Merged web
386:Normal web
336:Embryology
324:and has a
310:syndactyly
292:Database.
130:syndactyly
114:(daktylos)
98:(from
96:cleft hand
92:split hand
59:syndactyly
18:Cleft hand
2733:Scoliosis
2540:Hemimelia
2425:Pes cavus
2418:Flat feet
2399:Club foot
2331:Coxa vara
1057:eMedicine
1030:. Mosby.
840:Wood frog
759:Freakshow
697:Sporadic
643:century.
451:Treatment
353:Diagnosis
347:gestation
168:Syndrome
107:(ektroma)
67:Specialty
2783:Cervical
2230:shoulder
2226:clavicle
2208:dysmelia
2059:(OMIM):
2050:(OMIM):
1897:18593670
1839:10311465
1811:In Vitro
1796:86275852
1726:ABC News
1708:15249100
1659:19380058
1574:14239859
1522:17661743
1481:17996777
1372:25692622
1364:22121204
1329:12690205
1270:12668597
1208:15121782
1154:20138711
972:22043435
878:See also
786:1960â61
771:Zimbabwe
742:Nip/Tuck
490:The feet
316:Genetics
161:Genetics
112:ÎŽÎŹÎșÏÏ
λοÏ
2798:sternum
2130:C574275
1888:2610075
1753:6710256
1621:7594304
1423:3656376
1414:1050214
1320:2882961
1299:Bibcode
1290:Science
1199:1735762
1009:8737656
963:3191709
871:Terrier
831:Animals
602:History
542:IIB/III
343:Myleran
105:áŒÎșÏÏÏΌα
2821:other:
2535:Amelia
2412:valgus
2119:225300
2061:183800
2052:183600
1949:864231
1947:
1895:
1885:
1837:
1831:885563
1829:
1794:
1751:
1706:
1657:
1619:
1572:
1520:
1479:
1421:
1411:
1370:
1362:
1327:
1317:
1268:
1206:
1196:
1152:
1115:
1034:
1007:
970:
960:
919:
780:Soviet
767:Vadoma
729:Vadoma
118:digits
74:
2788:Bifid
2669:other
2586:Axial
2393:varus
2141:32141
2108:755.4
2093:Q71.6
1835:S2CID
1792:S2CID
1368:S2CID
534:I/IIA
146:SHFM1
102:
94:, or
2774:ribs
2341:knee
2217:Arms
2204:limb
2125:MeSH
2114:OMIM
2103:9-CM
1945:PMID
1893:PMID
1827:PMID
1749:PMID
1704:PMID
1655:PMID
1617:PMID
1570:PMID
1518:PMID
1477:PMID
1419:PMID
1360:PMID
1325:PMID
1266:PMID
1204:PMID
1150:PMID
1113:ISBN
1032:ISBN
1005:PMID
968:PMID
917:ISBN
765:The
581:Ueba
573:the
526:Type
372:Type
266:DLX5
126:SHFM
2304:hip
2295:Leg
2099:ICD
2084:ICD
2015:doi
1986:hdl
1976:doi
1937:doi
1883:PMC
1875:doi
1819:doi
1784:doi
1696:doi
1647:doi
1609:doi
1562:doi
1508:doi
1469:doi
1409:PMC
1401:doi
1352:doi
1315:PMC
1307:doi
1295:300
1256:doi
1194:PMC
1186:doi
1142:doi
1055:at
997:doi
958:PMC
950:doi
754:AMC
630:At
416:III
405:IIB
394:IIA
304:).
2853::
2466:/
2314:/
2228:/
2206:/
2190:/
2139::
2128::
2117::
2106::
2091::
2088:10
2011:22
2009:.
1984:.
1972:59
1970:.
1966:.
1943:.
1933:68
1931:.
1891:.
1881:.
1869:.
1865:.
1847:^
1833:.
1825:.
1815:13
1813:.
1790:.
1780:38
1778:.
1761:^
1745:65
1743:.
1724:.
1702:.
1692:29
1690:.
1678:^
1653:.
1643:25
1641:.
1629:^
1615:.
1605:20
1603:.
1591:^
1568:.
1558:46
1556:.
1552:.
1530:^
1516:.
1504:49
1502:.
1498:.
1475:.
1465:32
1463:.
1431:^
1417:.
1407:.
1397:24
1395:.
1389:.
1366:.
1358:.
1348:49
1346:.
1323:.
1313:.
1305:.
1293:.
1287:.
1264:.
1252:12
1250:.
1244:.
1216:^
1202:.
1192:.
1182:41
1180:.
1174:.
1162:^
1148:.
1138:35
1136:.
1063:^
1003:.
993:63
991:.
966:.
956:.
946:26
944:.
940:.
812:,
778:,
598:.
550:IV
427:IV
349:.
308:,
90:,
2800::
2776::
2176:e
2169:t
2162:v
2101:-
2086:-
2076:D
2021:.
2017::
1994:.
1988::
1978::
1951:.
1939::
1899:.
1877::
1871:4
1841:.
1821::
1798:.
1786::
1755:.
1710:.
1698::
1661:.
1649::
1623:.
1611::
1576:.
1564::
1524:.
1510::
1483:.
1471::
1425:.
1403::
1374:.
1354::
1331:.
1309::
1301::
1272:.
1258::
1210:.
1188::
1156:.
1144::
1121:.
1040:.
1011:.
999::
974:.
952::
925:.
826:.
816:.
762:.
558:V
438:V
383:I
124:(
34:.
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
