The hand abnormality in ulnar deficiency can include missing digits (so- called ectrodactyly) and syndactyly (abnormal joining of the fingers). I have previously blogged about ulnar deficiency- multiple examples are seen on this page. Also, I have written on multiple occasions about syndactyly here.
The following case demonstrates many important points in the understanding and treatment of ulnar deficiency and syndactyly.
|Ulnar deficiency and syndactyly|
|Palmar view of ulnar deficiency and syndactyly|
This child has a relatively normal forearm (slightly short ulna only) without deviation of the wrist. He has great wrist motion along with good elbow motion and forearm rotation. He has a great thumb, a full thumb web space, and two really good fingers. However, the fingers are joined together (syndactyly). To further promote hand function with independence of the fingers, the family and I elected to separate the fingers.
|Syndactyly flaps from top of hand|
|Syndactyly flaps from palm side.|
The flaps are elevated and sutured into place. We use absorbable sutures so nothing has to be removed and place a bulky dressing for 3 weeks.
|Syndactyly reconstruction from top of hand.|
|Syndactyly reconstruction from palm view.|
We performed this surgery as we believe it will take a really good hand in a child with ulnar deficiency and syndactyly and make it functionally better.
My Bio at Washington University