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Hand deformities


Impairment of hand function can lead to severe disability and is a common presentation.

Causes

Congenital

Failure of formation

  • ●

    Absent digit

  • ●

    Finger and thumb hypoplasia

  • ●

    Radial club hand

  • ●

    Macrodactyly

Failure of separation

  • ●

    Syndactyly (fusion of digits)

  • ●

    Camptodactyly

Duplication

  • ●

    Polydactlyl

Primary muscle contractures

  • ●

    Arthrogryposis multiplex congenita

Acquired

  • ●

    Dupuytren’s contracture

  • ●

    Rheumatoid arthritis ( Fig. 32 )

    Figure 32, Rheumatoid hand deformity .

  • ●

    Osteoarthritis

  • ●

    Trauma

  • ●

    Burns

  • ●

    Volkmann’s ischaemic contracture

  • ●

    Brachial plexus lesions

  • ●

    Peripheral nerve lesions

  • ●

    Spinal cord lesions

    • ●

      Poliomyelitis

    • ●

      Syringomyelia

  • ●

    Multiple chondromas (Ollier’s disease)

History

Congenital

These presentations will be recognisable at birth. Arthrogryposis multiplex congenita is due to non-differentiation of mesenchymal tissues, often together with a neurogenic element, the combination producing gross contractures.

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