- Dedos cortos: Braquidactilia, Simbraquidactilia, Síndrome de la Brida Amniótica
MALFORMACTIONS WITH SHORT FINGERS
The symbrachydactyly is one of the most common malformations of the hand. It consists of short fingers (brachy-), which can be linked together (syn-of syndactyly).
The severity varies widely: from short fingers, which may be attached (syndactyly) to the total absence of the fingers (Figure 10 and 11).
Figure 10. Mild symbrachydactyly. Shorter index and middle fingers shorter, with syndactyly.
Figure 11. More severe symbrachydactyly. Absence of index and middle fingers.
The ring and little fingers are shorter and present syndactyly.
This condition is not associated with systemic problems or is inherited.
We need to explore the chest, as it may involve an absence of part of the pectoralis major muscle (Poland Syndrome, Fig 12). We can improve the aesthetic by transferring other muscle, therefore improving the contour of the chest.
Figure 12. Poland Syndrome. The symbrachydactyly can be associated with the
absence of the pectoralis major, creating a deformity in the thoracic area.
Treatment depends on the degree of absence of the fingers. Children with a competent thumb, and the presence of any finger, generally do not require treatment because they develop a hand pinch with time. More severe forms may be tributaries of transfers of toes to the hand, in order to create a hand pinch.
The fingers are shorter but are not linked together (syndactyly), they are fully trained and have proper mobility. (Figure 13) Typically accompanies other syndromes.
Figure 13. Severe brachydactyly. In this case the patient requires surgical reconstruction to improve hand function.
Amniotic band syndrome
(Read section amputation / amniotic band syndrome)
In this syndrome, there are often short fingers by an amputation that occurs within the uterus. In addition, there are often syndactylies (fingers together) and constraints on the fingers (Figure 14 and 15).
Figure 14. Hand deformities secondary to amniotic band syndrome.
Amputated fingers, with constrictions and syndactyly.
Figure 15. Brida o constrición severa del dedo índice con riesgo de riego sanguíneo que requiere Z plastia preferente.
Band or severe constriction of the index finger, with risk of insufficient blood supply. This requires preferential Z-plasty surgery.
Figure 16. Results of the Z-plasty of the index, with recovery of blood supply to the finger.
Dr. Francisco Soldado is a specialist in children's upper extremity problems and in the reconstruction with microsurgical techniques of the extremities of children.
In his efforts to perfect treatment strategies and techniques, he has collaborated with multiple reference centers around the world.
Hospital de Nens
Carrer Consell de Cent, 437
Unidad de Cirugía Artroscópica
C/ Beato Tomás de Zumárraga 10 Hospital Vithas San José, 4ª Planta
Vall d'Hebron Hospital Campus
Passeig de la Vall d'Hebron, 119-129
Centro Médico Teknon
Carrer de Vilana, 12