PEDIATRIC DIGITAL DEFORMITIES Flashcards
cleft foot (lobster foot, split foot); absence of 2 or 3 central rays
Absence of 2nd-4th toes & mets, giving a clef in the forefoot
Ectrodactyly
supernumerary digits
Polydactylism, autosomal dominant!
name this classification based on location of extra digit?
supernumerary digit on medial side of hallux or foot
Preaxial Polydactylism
name this classification based on location of extra digit?
duplication of digits lateral to 2nd toe, 3rd toe, & 4th toe
Central Polydactylism
name this classification based on location of extra digit?
supernumerary digit lateral to 5th toe
Postaxial Polydactylism
name this classification based on tissue differentiation?
well-formed extra digit that articulates with the metatarsal
Type A Polydactylism
name this classification based on tissue differentiation?
extra digit is not well-formed; looks like an extra digit skin tag
Type B Polydactylism
name this classification based on tissue differentiation?
combo of A & B, partially formed toe w/ some bone or cartilage
Type M Polydactylism
what is this association of polydactylism?
short limb to dwarfism w/ no trunk involvement; auto. recessive tibial hypoplasia, polydactyly of hand, congenital heart disease, septal defects
tibial hypoplasia, polydactyly of hand, congenital heart disease, septal defects
nail dysplasia
Ellis-van Creveld Syndrome
what is this association of polydactylism?
causes low birth weight for gestational age
polydactyly, hypoplastic nails, 5th finger overlaps 4th clinodactyly
trisomy 13
patau syndrome
primarily caused by a taut abductor hallucis
Secondary causes are short 1st met, metatarsus varus, & diastrophic dwarfism
Surgical correction is only treatment
Congenital Hallux Varus
hitch hikers toe, club foot, & short limbs
Diastrophic Dwarfism
local gigantism of digit due to genetic input (can be manifestation of systemic issue)
Associated w/…
Neurofibromatosis Von Recklinghouse disease Hyperplasia of lymphatics or adipose Arteriovenous fistula Increased circulation to the digit
Macrodactylism
mutation in short arm of chromosome 17
Causes neurofibromatosis in 1 out of 3000
café au lait spots (6 or more in number, 5mm diameter)
Von Recklinghouse disease
dorsal overriding 5th toe, hyperextended & adducted 5th toe across base
of normal 4th toe
Called clinodactyly in hand
- Stretching, strapping, splinting
- Surgery in adolescence
Congenital Digitus Minimum Varus
(aka curly toe) toes are plantarflexed, medially deviated, & rotated laterally at DIPJ
-Bilateral & symmetrical
-Cause – hypoplasia of intrinsic muscles of the toe
o increased familial incidence
-Treatment – neglect, budding splinting, digital devices, MPC (moldable podiatric compound)
Varus Toe
any degree of webbing or fusion of fingers or toes
cause-autosomal dominant
epidemiology-seen more so in males, toes 2-3 have the greatest frequency, zygodactyly most common
syndactyly
name this conditions associated w/ syndactyly?
short toes
Brachydactyly
name this conditions associated w/ syndactyly?
(acrocephalosyndactyly) growth disturbances in head, hands, & feet
Premature synostosis of cranium, synostosis of phalangeal joints, fusion of tarsal bones
Syndactylism of metatarsals & digits
Polydactylsm
Apert’s Syndrome
name this conditions associated w/ syndactyly?
fusion of distal phalanges, asymmetrical breasts, & webbing of axilla
Poland’s Syndrome
name this conditions associated w/ syndactyly?
(aka fibrous dysplasia) polysyndactyly, club foot, long bone dysplasia
Albright’s Syndrome
name this Classification of syndactyly?
partial or complete webbing of the 2nd & 3rd toes
The most common syndactyly clinically
Usually a cosmetic problem
Type I Zygodactyly
name this Classification of syndactyly?
syndactyly of lateral most 2 toes + polydactyly of the 5th toe
Usually a functional foot problem (not just cosmetic)
Type II Syncopolydactyly
name this Classification of syndactyly?
fusion of metatarsals or metacarpals
Type V Metatarsals & Metacarpals
long, slender, spider-like fingers; associated w/ Marfan Syndrome
Arachnodactyly
flipper-like appendages due to Thalidomide exposure in the 1st trimester
Phocomelia
