AbstractNumerous previous reports have suggested an association of elevation of the distal axial triradius on the palm with congenital heart disease. Our investigation, however, in which the maximum atd angles of children with (isolated) congenital heart malformation were compared with the measurement in children with functional heart murmurs (controls), revealed no statistically significant difference in any of seven types of heart defects investigated. Only in males with tetralogy of Fallot was there even a suggestive (but nonsignificant) trend towards elevation of the atd angle. The fact that in our study the data were corrected for age of the subjects may account for the difference between these observations and those of some earlier reports. It appears unlikely that screening the position of the distalmost axial triradius in ostensibly normal newborn infants will be useful in predicting the subsequent appearance of signs of a congenital heart malformation, as has been suggested by other workers.