The Journal of Bone and Joint Surgery (American). 2009;91:19-25.
doi:10.2106/JBJS.I.00284
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Upper-Limb Evolution and Development: Skeletons in the Closet

Congenital Anomalies and Evolution's Template

Amy L. Ladd, MD1

1 Robert A. Chase Hand and Upper Limb Center, Department of Orthopaedic Surgery, Stanford University, 770 Welch Road, Suite 400, Palo Alto, CA 94304. E-mail address: alad@stanford.edu

The first 150 words of the full text of this article appear below.


   Introduction
 

There was an Ape in the days that were earlier;

Centuries passed, and his hair became curlier;

Centuries more gave a thumb to his wrist—

Then he was MAN, and a Positivist.

(Edward James Mortimer Collins [1827-1876], from: "The British Birds. A Communication from the Ghost of Aristophanes"1)

The human hand evolved from a specialized fin some 400 million years ago, and its many shapes and purposes have culminated in a masterful instrument capable of great skill—and a source of great despair. When things go awry in development, aberrancies range from the appearance of simple webbing and skin tags to the disappearance of the radius and mirror hand duplication. As surprising and rare as these conditions are, they occur in patterns of morphologic consistencies, although the inciting genetic programming and signaling pathways are complex, interrelated, and only provisionally understood. Identifying the gene's role in evolution has hallmarked much of . . . [Full Text of this Article]


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