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Journal of Bone and Joint Surgery, 1920;2:639-668.
© 1920 by The Journal of Bone and Joint Surgery, Inc


CONGENITAL MALFORMATIONS AND DEFORMITIES OF THE HAND

ARTHUR STEINDLER M. D., F. A. C. S.

1. Of the 25 cases reported, hereditary tendencies were in evidence in 5 cases, deformities of the hand being found in other members of the family in 3 cases, other deformities or anomalies in 2 instances. Identical deformities in family twice, one case of syndactyly and one case of congenital club hand.

2. Complicating deformities of the extremities were found in 15 cases, among which complicating deformities of the hand 4, namely; Symphalangism in 1 case of syndactyly; Syndactyly in one case of congenital ulnar club hand; Syndactyly in one case of contracted club hand, and Syndactyly in one case of lobster claw hand.

3. Complicating deformities of the spine and thorax were found in 3 cases.

Rhachitic deformities of spine and thorax in 1 case of syndactyly.

Congenital scoliosis with wedge shaped vertebrae in 1 case of contracted club hand.

Elevation of scapula, wedge formation of vertebrae and fusion of ribs in one case of congenital contractures of the fingers.

4. Complicating signs of degeneration and general developmental aberrations were found in 5 cases:

Acrocephaly in 1 case of syndactyly.

Malformation of genitals, high palate in 2 cases of contracted club hands.

High palate, malformation of maxilla in 1 case of contracted club hands.

Cleft palate in 1 case of aphalangism.

Three cases of this group showed deformities and contractures in all extremities.

5. Birth complications were found in 4 cases. Instrumental delivery in 3 cases (1 syndactyly, 2 congenital club hands).

Twin birth and chord constriction in 1 case (contracted club hands and general contracture).

6. Primary developmental errors were assumed to be the causative agent in the majority of cases, in one case only amniotic constrictions could be held responsible; polyglandular (endocrine) dysfunction was suggested in 3 cases by malformation of the bones of the head and genital hypoplasia.


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