A Rare Syndrome of Five Finger Hands and Polydactyly of the Feet

[hermantheshocker]

A 22-year old man was referred from the Welfare Organization for evaluation of his hands and feet abnormalities. The family history was negative for any congenital abnormalities. The parents were non-consanguineous. It seemed that the hands and feet deformities were symmetric. The right and the left thumbs were absent (Figs. 1 and ​2). The thenar prominences were absent and the first web space was narrow on both sides. The right and left hands had five fingers. The most radial fingers were in the same plane of the other fingers and they could not be opposed to the other fingers. He had a side-to-side pinch between the most radial finger and the index finger of his hands. He was able to grasp objects with all the fingers of both hands.


Fig.1 Dorsal view of the hands.


Fig.2 Palmar view of the hands.


Fig.3 Polydactyly of the feet.

The arcs of wrists flexion-extension were the same on both sides and they were 70° of flexion and 45° of extension. The right elbow had a normal range of motion. The left elbow’s range of motion was 40 to 120° of flexion. The active supination-pronation arc on the right side was 100°. The active supination-pronation arc on the left side was more restricted than the right side and it was about 40°.

The pronounced restricted ranges of movements on the left side might be explained by relative underdeveloped osseous structures and soft tissue abnormalities. The patient had polydactyly of the feet (Fig. 3). Each foot had seven toes. Legs and the ankles appeared normal on the both sides. No chromosomal abnormality was found on karyotype.


Fig.4 Radiography of the hands.


Fig.5 Radiography of the left wrist.


Fig.6 Radiography of the right wrist.

Radiographs of the hands showed that the most radial digits had a complete metacarpal and three phalanges (Fig. 4). The skeletons of the wrist joints were abnormal. Radiograph of the right wrist showed a hypoplastic distal radius and a rudimentary scaphoid. The trapezium, trapezoid and capitate bones in the distal carpal row had coalition (Fig. 5). Radiograph of the left wrist revealed a hypoplastic distal radius and a rudimentary ossicle instead of the scaphoid. The trapezium, trapezoid and capitate bones in the distal carpal row had coalition. The lunate and triquetrum were also fused (Fig. 6).


Fig.7 Antro-posterior radiography of the feet.

Radiographs of the feet demonstrated seven digits and six metatarsals. The second and third medial digits were articulated with the second medial metatarsal at the metatarsophalangeal joints on both sides (Fig. 7). To improve the function and aesthetic of the hands’ pollicization of the most radial fingers of the hands were considered but the patient declined surgery.

One explanation for the abnormalities of the limbs in this case might be that the genetic abnormality altered the AER and ZPA the activities. Failure of the signals to reach the preaxial side from the AER leads to abort the development on the preaxial side of the feet and produce absence of the thumbs in the hands. Ectopic ZPA morphogenic signals on the preaxial side of the limbs lead to produce five-fingered hands and mirror feet anomalies. In hand ectopic ZPA signals on the radial side of the index finger produce finger duplication. In this case, the anomalies might be a rare syndrome of atypical mirror hands and mirror feet.

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This post is for educational purposes only and is nonprofit. Under Section 107 of the US Copyright Act of 1976; Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. No copyright infringement intended. This post does not encourage or glorify violence or harassment. All/some of the images have been upscaled and sharpened/enhanced. The text might have been shortened and simplified, and/or reorganized for online view. Original case report by Afshar A. - J Hand Microsurg 2011.

[Sa Bal]

Dude could play 6 octaves at once on the keys wow those hands are wild as hell

[Karma]

I had a polydactyl cat. Never seen it in humans.

[techfreak76]

Very Interesting Case! I would not do a Surgery when there are no problems with the missing Thumb.

[woodsetton]

We had a set of twins, male and female at my high school who were nasty scumbags, abusive, mean, not very bright but able to make everyone's life miserable around them. They both had this deformity but it didn't stop the boys from several local schools screwing the girl. She was pregnant at 14 and no one, including her had any idea who the father was. I wonder if her kid had this deformity too.

[Suicide_Note]

Originally Posted by Karma

I had a polydactyl cat. Never seen it in humans.

I had a pterodactyl when I was a wee lad. I could never get the damn thing house broken, so we had to get rid of it.

[Exoroe]

I'm I'm awe that the human can devolve (or evolve) like this. Quite extraordinary.

[smacky]

Imagine the typing game on this dude. He can write a novel in seconds!

[Shadolife]

That's fuckin' creepy, thank you H

[Johnthejedi24]

Originally Posted by Exoroe

I'm I'm awe that the human can devolve (or evolve) like this. Quite extraordinary.

I wouldn’t call it an evolution or devolution, it’s a mutation that’s not really to any benefit.