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CC BY-NC-ND 4.0 · Journal of Morphological Sciences 2019; 36(04): 295-298
DOI: 10.1055/s-0039-1688808
Case Report
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Morphological Variations of an Atypical Cleft Hand: A Cadaveric Case Report

Srinivasa Rao Sirasanagandla
1   Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Al Khoudh, Oman
,
Mohamed Al Mushaiqri
1   Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Al Khoudh, Oman
,
Hussein Saleem Jawad Al Khabori
2   College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Al Khoudh, Oman
,
Roaa Abdullah Mohsin Al Rashdi
2   College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Al Khoudh, Oman
› Author Affiliations
Further Information

Publication History

21 January 2019

28 March 2019

Publication Date:
08 August 2019 (online)

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Abstract

Cleft hand is a group of hand deformities in which the central digits of the hand are congenitally absent. The soft tissue variations of cleft hand are rarely described. Hence, we report the anatomic variants of a unilateral atypical cleft hand with the absence of all of the phalanges of the middle finger. The 2nd and 3rd lumbricals showed a variation in their distal attachment. Both the superficial and deep flexor digital tendons of the missing middle finger were fused and inserted into the palmar surface of the head of the 3rd metacarpal bone. The extensor digitorum tendon of the missing finger was inserted on the dorsal surface of the head of the 3rd metacarpal bone. The palmar digital nerves of the median nerve of the middle finger formed 2 visible fibrotic masses; radial and ulnar, over the base of the 2nd web space. Of these, the radial mass was formed by the fusion of both palmar digital nerves and the common palmar digital artery. The knowledge of soft tissue abnormalities reported here is clinically important to plastic surgeons while restoring the good grasp and pinch of the cleft hand. The occurrence of fibrotic masses reported in the present case is unique, and these masses may cause diagnostic errors during an angiographic procedure.

Keywords

lumbrical - cleft hand - variation - plastic surgeon - deformity

Financial Disclosure

None to disclose.


 

  • References

  • 1 Sadler TW. Teratology. 11th Edition. New Delhi: Wolter Klauer Health (India) Pvt. Ltd; 2009. . Clinical correlates. In- Skeletral system (ch. 9). Langman's medical embryology; pp. 136–41.
    Search in Google Scholar
  • 2 Buss PW. Cleft hand/foot: clinical and developmental aspects. J Med Genet 1994; 31 (09) 726-730
    CrossrefPubMedSearch in Google Scholar
  • 3 Swanson AB. A classification for congenital limb malformations. J Hand Surg Am 1976; 1 (01) 8-22
    CrossrefPubMedSearch in Google Scholar
  • 4 Baba AN, Bhat YJ, Ahmed SM, Nazir A. Unilateral cleft hand with cleft foot. Int J Health Sci (Qassim) 2009; 3 (02) 243-246
    PubMedSearch in Google Scholar
  • 5 Durowaye M, Adeboye M, Yahaya-Kongoila S. , et al. Familial ectrodactyly syndrome in a nigerian child: a case report. Oman Med J 2011; 26 (04) 275-278
    PubMedSearch in Google Scholar
  • 6 Tertarry SA, McKuisk VA. Absence deformities as isolated malformations. In: Bergsma D, Mudge JR, Paul NW, Greene Sc. , editors. The Genetics of Hand Malformations. New York: Alan R Liss, Inc; 1978: 36
    Search in Google Scholar
  • 7 Durand S, Delmas V, Fox M, Hivelin M, Oberlin C, Guero S. Anatomic variations in a cleft hand of an elder cadaveric specimen. Surg Radiol Anat 2009; 31 (02) 145-148
    CrossrefPubMedSearch in Google Scholar
  • 8 Ueba Y. Buck-Gramcko D.Cleft hand.Congenital Malformations of the Hand and Forearm. 1998. London: Churchill Livingstone; 199-215
    Search in Google Scholar
  • 9 Snow JW, Littler JW. Surgical treatment of cleft hand. In: Transactions of the International Society for Plastic Reconstructive Surgery, Fourth Congress, Rome., Excerpta Medical Foundation. 1967: 888-93
    PubMedSearch in Google Scholar