Orthopedics - Oleksa A.P. 2006

Congenital malformations of the upper limb
Congenital hand deformities
Brachiphalangia, brachydactyly, and brachymetacarpia

These types of congenital anomalies can be hereditary.

Brachyphalangia is the underdevelopment of the finger Phalanges caused by premature fusion of the epiphysis with the metaphysis of the phalanx. As a result, the phalanx is short and smaller than normal, though apart from a cosmetic defect, it does not cause the patient any discomfort. Brachyphalangia may be associated with other Congenital hand malformations, such as Syndactyly, polydactyly, shortening of one or more Metacarpal bones—brachymetacarpia, or brachymetatarsia (Fig. 125).

Brachydactyly is the shortening of one or more fingers due to the underdevelopment or absence of phalanges. Sometimes brachydactyly is combined with the shortening of the metacarpal bones.

Most commonly, these developmental anomalies occur in the fifth and second fingers of the hands, less frequently in the third and fourth. Occasionally, simultaneous underdevelopment of the musculotendinous apparatus occurs, which impairs the function of the affected fingers. In such cases, due to involvement of the deep flexor and extensor of the distal phalanx, its flexion and extension are severely restricted, up to their complete absence.

The issue of treating these developmental anomalies is now approached with somewhat more encouraging Prospects. Although children quickly adapt to these defects and adjust to everyday life, they are prescribed massages, physical therapy, and training in relevant occupational skills and a profession. Currently, lengthening of shortened fingers using distraction techniques, toe-to-hand finger transplantation, and other Procedures are possible. Tyazhelkov A.P. (1986) reports the restoration of 81 fingers in 37 children with underdeveloped fingers using the method of distraction epiphyseolysis of the proximal phalanges and metacarpal bones, as well as following osteotomy of the phalanges and metacarpal bones. Through angiographic studies, the author revealed vascular underdevelopment in the hypoplastic fingers. With a normal rate of distraction, the vessels developed well, whereas with an accelerated rate, they developed poorly.