There are, by different symbrachydactyly classifications, 7 types:
- short finger
- cleft type (thumb and small finger present)
- peromelic (nubbins)
- monodactyly (only the thumb present)
- wrist bones present (but nothing more distal)
- wrist bones absent (ie, arm ends at the end of the forearm)
- transforearm (amputation at mid forearm level)
|Symbrachydactyly xray, severe cleft ype.|
We treated him years ago with lengthening of the 5th metacarpal to allow functional pinch. For several years he did well but now is limited by an inability to bring the thumb to the small finger ray. Please note that we did not correct the thumb (despite the triangular shaped bone) because the deformity was helpful.
|Symbrachydactyly after lengthening. Note the longer 5th metacarpal.|
|Symbrachydactyly after lengthening.|
|Symbrachydactyly on right, normal hand on left.|
We have discussed options with family including a surgery on the the 5th metacarpal (the lengthened bone) to angle it towards the thumb. However, we have all agreed to attempt to treat this without another surgery at this point. We will create a "post" to lengthen the small finger further (occupational therapy and prosthetics) to assess whether this helps functionally. If it does (stay tuned for pictures), a formal prosthetic can be constructed.