Finger Deformities


Clinodactyly is a curvature of a finger (or thumb).  The bend is in relation to the next finger rather than towards the palm or towards the top of hand.  This is not to be confused with camptodactyly as we discussed in a previous post, .  Additional information, as always, is available from our website,
Small finger clinodactyly with bending of the small finger towards the ring finger

Clinodactyly most commonly affects the small finger and causes a bending towards the ring finger through the middle phalanx.  However, clinodactyly can occur in any finger and often affects the thumb in children affected by syndromes (Downs syndrome, Aperts syndrome).  A complete listing of associated syndromes is beyond the scope of this review but more can be found at

Unusual clinodactyly of the index finger.

The middle phalanx is typically the site of an abnormal growth plate.  The growth plate is usually only at the base of the finger bone but in this situation, there may be a growth plate around one side of the bone- a “bracketed epiphysis.”  This actually causes abnormal growth with one side growing more slowly, thus causing the curvature of the finger.  This typically worsens with age.

Clinodactyly xray with abnormal growth plate of middle phalanx, a “bracketed epiphysis.”  This leads to abnormal growth and worsening of the abnormality with time.

In most cases, clinodactyly is not severe and is most often an appearance issue rather than a function problem.  However, when severe or if particular activities are limited, surgery can be considered.  In young children, I prefer a simple procedure which divides the abnormal growth plate, thus correcting the tether from the bracketed epiphysis.  This procedure does not provide immediate correction but allows gradual correction with growth.  It is performed in younger kids, ideally less than age 5.  This concept is not new and an early description of this technique was provided by Caouette-Laberge, .

It is more common that clinodactyly becomes noticed or problematic in older children, past the age where this simple procedure is effective.  In those children, the bone can be cut and realigned (an osteotomy) with good results.  There are a number of different techniques with all providing similar good outcomes.  One issue after this surgery is stiffness affecting the last joint in the finger (the DIP joint).  This improves over time.  We reviewed these two basic procedures in the following article:

Here are a few clinical photographs of patients before and after surgery.   Patients and families are typically quite happy with the results of surgery.

Clinodactyly after correction on the left hand small finger and before correction on the right.
A different patient with clinodactyly correction on the one pinky but not yet on the other.


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  2. My son has this on both his hands. They look EXACTLY like the photo above. I was wondering if I should be concerned. He has no developmental delays. He's extremely smart. He was born with hair all over his body, it has fallen out since then but is now growing dark hair on his legs at the age of 6? He is healthy and active, good growth, weight, height, etc. He makes little piglet noises when he eats and sometimes has difficulty with textured food. Especially rice. He also has little "fatty" deposits on the sides of the back of his head and sides of his neck. His regular pediatrician says there fine and may go away someday. No worries because they are not swollen. Curious, with all of these things together, should I be seeing a specialist of some sort? Just concerned that these things would be tied in together somehow and I would miss something important that should be reviewed.

  3. ColoradoMom,

    Thank you for the question. Your son's situation is interesting. And clinodactyly can be associated with syndromes and other anomalies. Yet, none of the specific points you raise are indicative to me of a specific issue. Importantly, I defer to your pediatrician who knows your son but your suspicions could be correct.
    Good luck.

  4. Hello, Your description of clindodactyly is the first description I have found that sounds like what my daughter has. I am not sure, however, because it seems to effect or be present in all of her fingers to some degree except her thumbs. It has progressively worsened so that at age 25 she is having a hard time using her fingers:hands for many tasks if everyday living. She also can't snap because of the position of her fingers, and is having a hard time with many fine motor things. She also complains that her fingers and palm, especially the palm area next to her thumbs, is very tight and stiff. I'm wondering if these things are consistent with clindactyly or not? Thank you very much. Laura

  5. Hello. I don't believe that I can be of much help. As I understand your description, this is not consistent with clinodactyly. A hand surgeon familiar with birth differences is your best resource for assessing and potentially helping your daughter.

  6. Dr Goldfarb,
    I find it very interesting there is a correlation between clinodactyly and downs. I have the curved pinkie which seems to be getting worse with age. I do not have downs but two of my sisters have had babies with downs and I have a cousin with downs. They've all been tested for the common downs hereditary gene but all have returned negative. Could it be possible that clinodactyly is an indicator of a hereditary gene that "carries" downs? Or is it solely found in those with downs themselves? Would appreciate your opinion on this.

  7. Hello and thank you for the great question. Clinodactyly is common and may be seen as an isolated finding or can be associated with other conditions like Downs. We certainly do not know each gene problem that may be associated with clinodactyly but it is possible that as we learn more about the humane genome, there could be a link. And as you likely know, Downs is caused by an extra chromosome whereas the error that causes clinodactyly is much smaller. I wish I could answer more definitively and really think your question is a good one.

  8. Dear Dr Goldfarb, My son (44) and daughter-in-law (36) are expecting a baby in July. The latest scan shows Clinodactyly in the pinkie of one of the hands of the fetus. Everything else seems to be normal. I see you say that Clinodactyly is common and may be seen as a isolated finding. Does this mean that even if there is no evidence of this condition in the family history, it can crop up randomly out of the blue? How high is the likelihood that in this case it could be associated to Downs or another syndrome?

  9. Worriedgran,
    Thank you for the question. I am glad everything seems ok aside from the isolated clinodactyly. While there are numerous associations (see OMIM), I often see clinodactyly as an isolated condition. Clearly, more information will be available at birth which will allow a more precise examination. US can help clarify potential diagnoses and clinodactyly does not confirm a particular diagnosis for me.

  10. I have it and I live with it no problems. Nobody seems to notice it and I had so much fun as a child telling my mean friends when they kicked the ball at me too hard for example that they broke my finger �� …. or tell wild stories about how I broke my finger. Of course I tell everybody the truth at the end. Even I forget about it sometimes and live my life.

  11. Hello Dr. Goldfarb,
    My wife and I recently noticed an underdeveloped index finger on our 9 month old's hand. It is very slight but noticeably shorter on his right hand then on his left, it is a also thinner from the middle to the tip of his finger, it is clinched 95% of the time even when he is opening up the rest of the hand. When he does open the finger it almost bends out to towards his thumb before he it goes out straight. Our pediatrician summed it up as an abnormality, but didn't think it needed to be looked at further. After pressing they referred us to an Orthopedic who took an X-Ray which to him looks normal with just one phalange looking on the small side, he has only recommended we stretch his finger in hopes it loosens the tendons which "he thinks may be tight" and if it gets tighter maybe surgery to release the tendon. They both think the shortness is just an abnormality but have no name for it. We just want to make sure we are not missing anything. Thank you.

  12. DBJR,
    Thank you for the question. I wish I were able to answer more definitively but I am uncertain what is your son's specific anomaly. A visit to a hand surgeon (ideally one who works with kids regularly) may be your best option. Good luck. Feel free to contact me offline if I can answer additional questions.

  13. Hi Dr. Goldfarb,
    I have clinodactylyl in both pinkies and I have never really given it much thought till recently. The bend is quite pronounced in my right pinky and I've noticed my phone always rests in the dip of the bend when I hold it. It kind of hurts sometimes and I feel like it's more bent than it used to be. At almost 21, could I fix it with minor surgery? Thank you in advance for your feedback!

  14. Victoria, thank you for your question. At your age (no offense), the surgery is not quite so simple but is still not complex. The bone is 'cut' and realigned. It can be a very effective solution. It requires pins in the finger for approximately 6 weeks and stiff of the last finger joint is sometimes a challenge. I hope this helps.

  15. Hi,

    I was wondering if it is common to have clinodactyly more predominantly in the index finger rather than the pinkie? If you look closely enough all my fingers are curved but the only ones immediately noticeable are the index fingers which curve inwards towards the other fingers. It's not severe but is significant enough that I can't properly manage bar chords on a guitar (for example). Most of the stuff I've seen talks about the pinky but, while mine are mildly affected, it's mainly my index fingers.

  16. Thea. The small finger is much more commonly involved compared to the index finger. Many people have a subtle curve or angulation of their fingers so this is not always a condition that needs treatment. But if a functional problem (ie, guitar), you may want to visit a hand surgeon to discuss your options. Good luck.

  17. Dear Dr. Goldfarb,

    I stumbled upon this page as I was searching for a term to describe my sons' crooked thumbs. Their paternal great grandmother and a few older cousins have inherited this gene. Their paternal grandfather and father have not. My oldest son is now 6 years old and both of his thumbs are curved. The right thumb is more severe and curves inward towards his ring finger about midway up and the left thumb curved outward, but like I said is not as pronounced as his right hand. So far it has not effected him in functional tasks so I have not bothered to pursue it. I have a six month year old son and his thumbs are just like his brothers. I read that it can worsen with age and am wondering if I should pursue this and contemplate treatment. I know that one of the cousins thumbs (he's in his 50's now) are not only curved, but cannot bend. I'm worried that this may happen over time..? Not sure if it's related but my oldest son's big toe has a joint that is pronounced on the inside. Any advice is greatly appreciated!
    Thank you in advance,

  18. Janine. Thank you for writing. The short answer is that yes- this can worsen over time. It would probably make sense so see a hand surgeon that specializes in children for an xray and assessment. Good luck.

  19. Hi Dr. Goldfarb,
    I am 17 and both my pinkies have clinodactyly. I measured the curvature of my right hand pinkie and it's at 40 degrees (a very rough measurement), and I was just wondering why someone would need surgery? How much worse does the curvature get over time and what could it affect in my day to day life? I am just wondering why someone would need surgery besides appearance, I most likely will not get it.

  20. Cat,
    Thanks for the question. First of all, you may never need treatment for the clinodactyly. If your fingers do not bother you now, they may never bother you. In my experience, things like typing or playing a musical instrument are most likely to be a problem. Finally, the surgery today is the same as any surgery you would have in the future (i.e., there is no harm in waiting).

  21. I have a daughter who was born with camptodactyly. It affected her 4th and 5th fingers on the left hand only. We took her to a pediatric orthopedic hand specialist, who told us to stretch out her fingers frequently (he suggested every time I nurse her). Anyways, after a year, the clinching of her fingers eased significantly. She is doing great now. However, I also have a son who always had a curve to his middle and ring finger (the middle finger curves toward the ring finger and the ring finger curves toward the middle finger). I never mentioned it to the doctor, but as he grows (he is 6 now), the curving seems to be more pronounced. Should I address this or is it just cosmetic? He doesn't seem to notice or care. His toes look a little strange too. It's like some of the toes pop toward more than others. Any information you have give would be greatly appreciated. Thank you.

  22. Thank you for the comment Christy. I agree that camptodactyly in newborns may be improved with stretching as you describe. However, sticking to the topic of this thread- clinodactyly- your son's finger may be affected. While many times this will not affect function, there are two question. First, will it get worse and may it affect function in the future. This is tough to predict but an x-ray may be helpful. And second, is there intervention now that differs from treatment in the future? If there is a bracketed epiphysis causing the curvature, it will get worse and can be simply treated now whereas at an older age, a bigger procedure may be required. The bottom line- I would take your son to the same congenital hand surgeon who gave you good advice about your daughter. Good luck.

  23. Dr. Goldfarb,

    My son was born with a right index finger that looks like the picture above labeled, "unusual clinodactyly of the index finger." It curves to the left near his thumb. We have now had two surgeries. The first one the doctor removed a portion of the growth plate in hopes that it would move to a straighter position. Unfortunately, it didn't move. This was done around the age of 18 months. He had another surgery in May of 2017. This was more aggressive. They cut the bone and reset it to be straighter. He had pins in his hand for about 6 weeks and the finger definitely looked more straight than ever. We just had our follow up today and the finger has moved again 30 degrees. We are now back where we started. We left thinking the best option is to wait and see what the finger does. I have never heard of this condition mentioned in this blog nor have I heard of the procedure to fix it. We are in the Atlanta area and I am now wondering if I should seek out other medical opinions. I would love your medical advice. Thank you.

  24. Thank you Bethanne. I am uncertain of why the finger has not maintained a straightened position and observation may well be the best option.

    Clinodactyly of the index finger is quite uncommon. The concept of the growth plate surgery at a young age is reasonable. I am uncertain why it did not work (how long did you watch- it can take years to see improvement because improvement depends on future growth) but it could be that there was not the classic bracketed epiphysis in your son's finger.

    An osteotomy often provides the definitive straightening if the growth plate surgery does not provide correction. One important concept is that the correction during the osteotomy procedure must be through the bone and not by hinging the joints open. That can lead to a false sense of straightening which becomes apparent once the pins are removed.

    Good luck.

  25. Hello
    Could you give me a advice please .
    I'm 36 years old and has 2 pinkie bend toes as well. No bother me but I have two wee girls 8 and 5 years old and have noticed they has too bend pinkies but not so bad 20 degree approx. Can any exercise or maybe taped the finger straight over the night can help ?
    Thank you

  26. Piotr,
    Thank you for the question. Unfortunately, neither exercises or taping will help clinodactyly. This is a bony problem. Thankfully, as you note, it does not 'bother' most people. But, if a real problem, surgery can help.

  27. Hi Dr. Goldfarb,

    So glad to find your blog. I have a 13 year old son that has bent pinkies (also relatively short). It's genetic and runs on my mom's side of the family. Everyone seems to live with them just fine until my son. He plays cello and the short and bent pinky demands lots of adjustments, some of which are not so easy. I have been looking into surgery. It seems that opening wedge osteotomy could add to length and it would be a great bonus. My concerns are recovery time and how well the pinky will function after surgery – there was some mentioning of stiffness. Could you tell me more about that? Thank you so much!

  28. Thank you for the question and your experience matches my own- most people do fine but some with fine motor requirements (like cello) can struggle. Surgery might make sense. Opening wedge osteotomy has been effective for us. The last joint (the DIP joint) can be stiff after surgery but responds over time to therapy. Typically, fingers are immobilized for about 6 weeks and then 4-6 weeks of therapy (mostly at home) are needed to recover fully. I hope this is helpful.

  29. Hi. My 17 week old premature boy has it on both pinkies on both hands and had it since birth. What other conditions other than downs syndrome can cause this? Can he have no conditions and still just have it? Obviously I worried mum here

  30. Hello. Congratulations on the birth of your boy. Most of the time, there are not associated syndrome with clinodactyly. As you have read, occasionally clinodactyly is associated with syndromes and conditions. These include chromosomal abnormalities, Apert syndrome, Rubinstein-Taybi syndrome, some types of dwarfism, and some of the brachydactylies (short finger conditions). Many of these syndromes and associations are obvious and you and your doctors would already know. Hopefully, your son has the isolated and idiopathic type.
    Good luck,

  31. I never realized this was a thing. My 8 year old son has had this on both his pinky fingers since birth. They are quite angeled (almost exactly the same as the first photo in the article. )and I've never really thought they could cause any issues. He does have a hard time holding pencils, utensils and similar item and properly. He doesn't have any pain in them though.

    What would you recommend to do, if anything ?

  32. Hi Dr,

    My son is 6 and has this on both his hands. They look exactly like the 1st photo above. He was born with them and they are becoming more curved. I am concerned. He has had developmental delays his speech, concentration is very little. But he is extremely smart he just lacks the ability to sit still. He is healthy and active, eating habits are poor same things sometimes none. He has outbursts, noises grunts or simply thinks he's a lion or lightning McQueen. I am concerned and he works hard but I can see its getting the best of him. I need help please… He will be starting Gr1 soon and I'm so scared they are going to dismiss him simply because he is so busy and not see how smart he is.

  33. Hello. Thank you for writing. Clinodactyly is common. It is most often an isolated issue but can be associated with other medical conditions and syndromes. I would suggest that his pediatrician further assess your son. Certainly, there are no easy answers that I can provide. Good luck.

  34. Hi Dr. Goldfarb, thank you for you answer 2 years ago. I'm back again with another question. I saw a hand surgeon in my hometown a few months ago for my clinodactyly and mentioned that the pain in my right pinky has gotten much worse. He took xrays but after told me that it wasn't a problem and that the surgery would only increase my problems with the condition. He told me to "go live my life". I left feeling disheartened because he's supposedly the top hand surgeon in my area, and because the pain is quite intense some days. My joint will lock sometimes but most of the time it's a constant ache in the right joint and can be as maddening as a constant toothache. Have you ever operated to correct clinodactyly in an adult? Or do you know of anyone who has? I'm looking for a second opinion to eventually resolve my pain. Thank you again!

  35. I am sorry to hear of your interaction. While sometimes surgery is not the answer, if the pain is severe, it could be an option. It is quite rare to operate on patients with clinodactyly in adulthood because it so rarely causes problems. But, I would look for another hand surgeon in the area for another opinion. Good luck!

  36. Hi sir,

    I having 1st child with rubbestine taybie syndrome and newly born one child having pinky finger, ring finger is one hand is not bending. on the other hand pinky finger, ring finger and index finger is not bending. Now she is 2Month responding and social smile and remaining all activity is good. Please suggest

  37. Hi just stumbled across this
    My son now 19 has both curve pinkies one more prominent than the other but never been an issue with him. My daughter also has the same but not much noticeable as her brother.
    My kids don't have any syndrome or conditions but there dad has the same.
    Could it be inherited?

  38. Hello. Clinodactyly may be random or idiopathic in some. But, in others there is a strong genetic component. If you search at the site, clinodactyly brings up a large number of genetic issues that are important. I hope that helps.

  39. Hi. I’m 19 years old and I have clinodactyly. My condition is not severe to where I’m not able to use my hands, but they are definitely a cosmetic issue. I want to get them fixed , but I don’t know where to go for a consultation .

  40. Savannah,
    Thank you for the comment, question. Honestly, not an unusual situation. The easy answer would be for me to say- see a local hand surgeon, ideally one who treat kids and adults and is familiar. But, I should add the following. The surgery is not without risks, even though small. These risks include issues with healing of the bone, possible infection, and stiffness of the DIP joint (the last joint in the finger). These risks do not mean you should not consider surgery but they are important for you to know and understand fully before undergoing surgery.

  41. Hello, I'm 22 years old medical student, during my plastic surgery rotation I recognize that I might have clinodactyly. My left pinky is a bit angled from DIP joint and also I'm left handed I have never had problems with hold or grip something in my life or clinical pratcie so far. I'm realy keen on surgery and I know there is no consensus on what degree of angulation justifies a diagnosis but I would like to know your opinion about it. Could this condition cause any trouble in the surgical practice.

  42. I have this on both pinkies bout a 30 degree angle and I have musicianship goals. I’m 27. I understand the stiffness in the last joint but would I at least be able to stretch my pinkies further than I can now.

  43. Hello Nemooo,
    Thank you for the question. Many with a clinodactyly of 30 degrees or less do just fine without any surgery. If you are finished with growth, the angle will not change over time. If you are currently struggling with musical instruments, surgery could be considered to realign the finger (and potentially add a small amount of length). There is indeed a risk of stiffness of the DIP joint.

  44. Thank you for all these answers and explanations. My son 21 months old has a very bent little finger and I noticed he crosses the ring finger over it and holds it crossed very often. Should I worry? Is there pain or discomfort associated with it? Would it be worth investigating it? Thank you.

  45. Teacher and Mum. Thank you for writing. No, honestly, this is not a major issue. Pain is rare. Really, the main concern is function and the potential that this angulation and cross over may affect function. There is a simple operation in the young patient to correct this but it can also be corrected as he gets older. I might talk to a congenital hand surgery if possible but not rush to any decisions.

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