Friday, April 10, 2015

Unusual Clinodactyly

I have written previously on clinodactyly with several posts.  Clinodactyly, the curved finger, is typically not a functional problem.  But, a more severe deformity is more likely to be a problem with activities and patients often complain of trouble with things like keyboarding and musical instruments.  Clinodactyly of the small finger is most common location and it almost always causes a deviation of the pinky towards the ring finger.  It is rare to see any other deformity.

This 17 year old patient has clinodactyly but with the very uncommon deviation away from the ring finger.  It does not cause pain but it does cause trouble with activities.


Notice the curved small fingers- clinodactyly- but with deviation away from the hand.


Close up view of small finger clinodactyly.

Finger flexion is good (almost always the case) in this patient with clinodactyly.
Clinodactyly.  Not the abnormal shape of the middle bone causing deviation.
Clinodactyly.  Not the abnormal shape of the middle bone causing deviation.

Thanks for reading.

Charles A. Goldfarb, MD
My Bio at Washington University
congenitalhand@wudosis.wustl.edu

13 comments:

  1. Hello. My name is Julia Nail. My Biology class has been working on a project, so my partner and I decided to research hand and arm malformations. Your blog (I think this is a blog.. I'm sorry if I'm incorrect) has shown up a lot while searching, therefore I thought it was a good idea to ask you questions and such. I would say one of my top questions is: Have scientists or doctors worked on a medication of some kind to either detect or prevent these malformations? I hope to hear from you soon. Thank you for your cooperation.

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    1. Julia, thank you for the question. And yes, this is my blog. Not a typical blog, I know, but my goal is simply to provide information for families. Doctors are always working to both detect and prevent these malformation. Prenatal US is pretty good (but far from perfect) in detection. Each of these malformations has a different cause and so there is no one medicine which can help prevent them. But, folic acid is a great example of progress. As you may know, pregnant women take folate to help prevent neural tube birth defects and it has been really successful in preventing that problem.

      I hope that helps somewhat . Good luck.

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  2. Hi Dr Goldfarb,
    My pinkie fingers curve in like the pictures shown above on both hands, as well as my ring fingers bend in towards my middle fingers & a few of my other fingers seem to twist slightly as well. Are there any common issues noted with these finger abnormalities? At 44, I am starting to have more significant joint pain & a more knobby appearances over the distal joints in both hands. Thank you in advance for your response.

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    1. Jenicat, I am uncertain of what exactly could be going on with your hands. I would recommend a visit to a hand surgeon for x-rays and an assessment. Clinodactyly is something that is usually present in childhood and does not typically present later. Arthritis is a possibility but your description does not fit classic arthritis. Good luck.

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  3. Thank you for your response! I apologize for not being clear. I have had the finger deformities since birth. They have recently become more prominent & painful. My question was if there were typical problems noted with Clinodactyly such as specific types of arthritis, etc.

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  4. Jenicat,
    Thank you for clarifying. There is not, in my experience, problems which classically develop in clinodactyly. I almost never see adults with this issue. However, if you are having more difficulty, there are likely good treatment options available.

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  5. Hello. I have clinodactyly that causes the 3rd and 4th digits of both of my hands to curve away from eachother, which sort of makes it look like I am always doing a Vulcan salute. I was wondering how uncommon this is. Thank you

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    1. Rik,
      Thank you for the question. I have not seen clinodactyly cause this presentation. Do you have x-rays showing middle phalanx anomalies of both fingers? I have seen other anomalies cause something similar. If not a functional issue, I would typically observe this but, depending on the x-rays, intervention could be considered.

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  6. Hey I have klinefelter syndrome and both my pinkies are curved like the picture
    I think theres a connection between the two since it's one of the less known symptoms of the syndrome

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    1. Thank you. Honestly, I needed to do some research to respond your question/ comment. Yes, there is a connection between Klinefelter syndrome and clinodactyly (as it is present in at least some patients). It is also noted in patients with XXXY. Thank you for sharing.

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  7. Hi, I write you from France.
    I have also this original clinodactyly, on my two hands. My father and brother have the same.

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  8. Dr. Goldfarb,
    I'm Sorry for resurrecting a fairly old thread here, but I wanted to comment to you, that I have had a clinodactyly of the tip of my RING FINGER- (right hand) bent inward at an angle towards my middle finger since Birth. I was also curious to know if you had ever seen that presentation in your practice thus far?
    I am now 35 years old (female) and had no other major birth defects.
    However, a few years ago I started to develop knuckle pads, which my father had, and I feel were at least in-part inherited. Unfortunately, the potential for progression or developing related intermingling diseases did not stop there for me. About 2 years ago I started to notice hard pea sized nodules on the palm of my right hand and a strange tightness in my left ring finger that almost felt as if it getting stuck when moving it. Dupuytren's.
    Fast forward to today and it has progressed rapidly. I have contrapures on my pinky and ring fingers of both hands, so all 4 stay partially closed to my palm, but very recently I have also noticed that my ring and middle fingers no longer want to Separate very far apart. I would say about half of what they could at their normal state, And that when I go to close my hands, both my index fingertip and pinky fingertip are curving inwards towards my palm, which is causing them to piggyback on my inner two fingers a bit, which is starting to give my hands the appearance of actually being "drawn in" to themselves.
    I have no idea if any one thing could have been set in motion by anything else, or could have been an identifying marker that something was to come, or if anything could possibly even be related to another,
    But that's my story. :)

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  9. Brittany- thank you for sharing your "story". Really interesting. I have seen ring finger clinodactyly but agree- very rare in isolation. I take care of hand issues in kids and adults so this question resonates. I have no knowledge of a connection between Dupuytrens and clinodactyly but we are still learning about both. The good news for you is that Dupuytrens has become a bit more straightforward to treat, at least for many with a needle aponeurotomy procedure. And the tightening between the fingers is also likely related to a Dupuytrens cord (a natatory cord). Good luck.

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