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Clinodactyly Deformity Simulating Trisomy-18 Hand Malformation

David E. Comings, MD; Joseph M. Delgado, MD
JAMA. 1970;213(7):1192. doi:10.1001/jama.1970.03170330072016.
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To the Editor.—  In trisomy-18 syndrome the hand has a characteristic deformity. There is flexion of the fingers with overriding and medial deviation of the index and little fingers. The dermatoglyphics in these individuals is characterized by a high percentage of arches. A child had a hand deformity closely simulating that seen in trisomy-18 and an increased number of arches, but there were no other congenital defects and no chromosomal changes. The presence of a similar defect in the mother suggested an autosomal dominant mode of inheritance.

Report of a Case.—  A 6-week-old female child had the hand changes shown in Fig 1 and 2. There was clinodactyly of the index and fifth fingers which caused them to deviate medially and overlap the ring and middle fingers. The child could freely extend the fingers (Fig 2) indicating an absence of flexion contractures. The manner in which this deformity mimics that


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