Teratological variants of congenital triphalangism of the 1st finger in children

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Abstract

 ased on examination of 56 patients, aged 8 months - 16 years, heterogeneity of congenital thumb three-phalangism was detected. Two forms of that pathology were defined: simple form (brachymesophalangeal, pseudothreephalangism, dolichophalangeal) and complex form (three-phalangism with combination of 1st radius hypoplasia and with combination of radial polydactyly). The main radiologic criteria to delimit one form from the other one are the following: longitudinal and transverse sizes of 1st metacarpal bone; location of 1st metacarpal bone epiphysis; sizes and shape of additional phalangx; longitudinal size of 1st radius: volume of 1st intermetacarpal interval. Detection of malformation type is of importance for the choice of treatment tactics.

About the authors

O. E. Agranovich

Research Children's Orthopedic Institute. G.I. Turner

Email: info@eco-vector.com
Russian Federation, St. Petersburg

I. V. Shvedovchenko

Research Children's Orthopedic Institute. G.I. Turner

Email: info@eco-vector.com
Russian Federation, St. Petersburg

S. I. Golyana

Research Children's Orthopedic Institute. G.I. Turner

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, St. Petersburg

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Supplementary files

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2. Fig. 1. Variants of the brachymesophalangeal form of triphalangism.

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3. Fig. 2. Transitional form from brachymesophalangeal to dolichophalangeal.

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4. Fig. 3. Pseudo-triphalangism.

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5. Fig. 4. Dolichophalangeal form of triphalangism: a — with a normal first interdigital space and an increase in the first ray to 20% of the age norm; b - with a reduced first interdigital space and an increase in the first ray by 20-40% of the age norm.

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6. Fig. 5. Transitional form from dolichophalangeal to brachymesophalangeal.

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7. Fig. 6. Combination of triphalangism with hypoplasia of the 1st ray. a — combination of brachymesophalangeal form of triphalangism with hypoplasia of the 1st ray; b — combination of dolichophalangeal form of triphalangism with hypoplasia of the phalanges, normally developed metacarpal I and carpometacarpal joint; c — combination of dolichophalangeal form of triphalangism with hypoplasia of the 1st ray.

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8. Fig. 7. Combination of triphalangism with radial polydactyly and isolated hand lesion. a - triphalangism in combination with radial polydactyly; b - triphalangism in combination with complete doubling of the first ray; c - triphalangism in combination with incomplete tripling of the 1st ray; d — triphalangism in combination with radial and central polydactyly of the hand without anomalies in the development of the forearm.

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9. Fig. 8. Triphalangism of the first finger of the hand in combination with radial and central polydactyly, as well as an anomaly in the development of the bones of the forearm.

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