Congenital Right Hand Syndactyly in a child: Plain Radiographic Features and Case Report

Abstract

Syndactyly is a Greek word meaning fused digits, may involve fusion of the soft tissues with or without bony fusion. It is regarded as the most common congenital defect of the hand, detected in 1 out of every 2000 live births, twice as common in males, and more among the Caucasians. This is a 10-month-old male infant that was referred for plain radiograph of the right hand on account of completely fused 2nd to 5th digits and an incompletely fused 1st digit with medial deviation since birth. The plain radiograph showed soft tissue fusion of the 2nd to 4th web spaces completely with a partially fused 1st web space. There is associated fusion of the distal phalanges of the 4th and 5th digit, foreshortening of the 3rd and 4th metacarpals with the middle phalanges of the 2nd and 5th digits. There is flexion of the interphalangeal joint and medial deviation of the 1st digit. There is also haphazard arrangement of the metacarpals and phalanges most especially the 3rd and 4th digits. Prominence of the thenar and hypothenar eminences with mild ulnar deviation of the entire right hand were also demonstrated. The contralateral left hand appears within normal limits, a complementary ultrasound showed normal abdominal organ situs. A diagnosis of congenital syndactyly most likely the complex-complicated form in a 10-month-old infant was established. The surgical repair to establish function and achieve excellent aesthetics was deferred until the child clocks about 24-months of age. We report a case of congenital syndactyly of the right hand due to its radiographic form of presentation in this 10-month-old infant.