VIDEO: WHAT IS CLINODACTYLY? Clinodactyly Causes, Symptoms, Treatment, Surgery * 2023
VIDEO: WHAT IS CLINODACTYLY? Clinodactyly Causes, Symptoms, Treatment, Surgery * 2023

Clinodactyly is an abnormal appearance of a finger

It is most common in the little finger, or 5th finger. The joint closest to the nail bed is abnormally angulated toward the ring finger, or 4th finger.

This is a minor congenital defect, and it does not get worse with age. Between 1%-20% of people are born with this condition.
Clinodactyly means that your child has a finger that curves to one side. It is typically caused by abnormal growth and development of the small bones of the finger.

Clinodactyly is a minor bone malformation where your finger curves at the joint closest to your nail and bends toward your other fingers like a hook. It most often affects your fifth digit (pinky finger), but it can happen to any finger or toe. The curve is the result of your finger bone growing in a different shape than it should. It may be present at birth, or it may happen as a result of injury to a growing finger in childhood.

It’s normal for fingers to curve at an angle less than 10 degrees. Clinodactyly specifically refers to finger curves at angles greater than 10 degrees.

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Clinodactyly can affect anyone

It tends to affect boys more often than girls. Having clinodactyly in both hands is also common. It’s more common among people assigned male at birth. When no other medical problems are present, the condition is called isolated clinodactyly.

It may also occur as part of a genetic syndrome, including Down syndrome, Turner syndrome and Klinefelter syndrome. About 1 in 4 people diagnosed with Down syndrome have clinodactyly.

The exact rate of occurrence is unknown, different studies have shown that 1% to 2% or as many as 20% of people may have clinodactyly. Clinodactyly is generally harmless and only affects how your fingers look, not how well they work.

Several genetic conditions affect bone growth and cause clinodactyly as a symptom. These conditions include:

  • Down syndrome.
  • Fanconi anemia.
  • Klinefelter syndrome.
  • Turner syndrome.
  • Triple X syndrome.

Causes and symptoms

Clinodactyly is caused by a developmental defect in the bones of the finger. This defect causes the bone to make a wedge shape instead of a normal rectangle.

There are three bones in the finger. In many cases, children develop clinodactyly when the middle bone is shaped like a triangle. This misshapen bone is called a “delta phalanx.”

A delta phalanx may have a curved growth plate or more than one growth plate. Therefore, as the hand grows, the finger becomes more curved. Clinodactyly can be passed on from parent to child. It may also be part of a related condition, such as Down syndrome.

Clinodactyly can be associated with many syndromes including Down syndrome, Klinefelter syndrome, Turner syndrome, Fanconi anemia and others.

The symptoms are often mild and go unnoticed. Patients may notice a bend in the finger. If the joint is turned more than 45 degrees, movement of the 5th and the 4th fingers can be impaired.

Symptoms of clinodactyly appear in a finger on your hand. The condition can be present at birth (congenital) even if symptoms aren’t noticeable until early childhood when the bones grow and start to mature. Clinodactyly could appear on one or both of your hands and on any one finger. The condition also affects toes.

Symptoms of clinodactyly include:

  • The finger curves like a hook or the letter C (at an angle greater than 10 degrees).

  • The curved finger bends toward other fingers (often the pinky finger pointing toward the ring finger).

  • Finger bends between the two knuckles in your finger.

  • The finger could overlap with other fingers on your hand.

  • The bent finger doesn’t cause pain or swelling.

  • Individuals with clinodactyly are still able to use their fingers normally.

  • Although rare, if the curve in your finger is greater than a 30-degree angle, you’ll have a limited range of motion in the affected finger, and you may need surgery to correct it.

Management and treatment

Treatment is aimed at improving function and cosmetic appearance. Specific treatment will be determined by a child’s doctor. Mild clinodactyly usually does not cause pain or problems with function. If your child has a mild curve, they probably do not need surgery.

However, clinodactyly can increase as the hand and fingers grow. Therefore, it is important for your child to be followed closely by their doctor in case their finger becomes more curved over time. If clinodactyly interferes with the use or movement of their hand, your child may need surgery.

Often, no treatment is required. In severe cases, treatment may include (alone or in combination):

– Corrective surgery (if the condition interferes with hand function)
– Closing, opening or reversing wedge deformities: These procedures remove a wedge-shaped piece of bone in order to re-create a normal rectangular-shaped finger bone.
– Tendon, skin or soft tissue operations to release the tension on the joint.
– Occupational therapy
– Physical therapy
– Splinting
– A device that is used temporarily to support or immobilize a limb that has a damaged joint or bone.

There are two main types of surgery for clinodactyly:

Physiolysis:

It is done in very young children who have a delta phalanx (triangle-shaped bone) that is causing their finger to grow more curved. The abnormal growth plate in the delta phalanx is removed, so the finger can grow more normally.

Osteotomy:

It is typically done in younger children with a more severe curve, and in older children and teenagers who have trouble using their hand due to the curved bone. In an osteotomy procedure, the curved bone is cut and straightened. It is generally held in place with pins and a cast until it heals.

Surgery is usually successful in fixing the curve, but there is a risk that the curve will come back. If it does, your child may need another surgery.

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