Anatomic variations in a cleft hand of an elder cadaveric specimen.
Cleft hand is a rare and complex malformation in which the central part of the hand is missing. Since the nineteenth century, a very small number of dissections in cleft hand have been reported and very few reports describe the soft-tissue abnormalities. We report a case of an elderly cadaveric specimen with bilateral cleft hand. X-ray, CT-scan with 3D reconstruction and dissection were performed on the right hand and forearm. On both the sides, we noted the absence of the index, middle and ring finger. Malformation and degenerative arthrosis at the carpal bones level have been identified. The flexor and extensor tendons of the absent fingers fuse with one another over the end of the remaining carpal bones, forming a radial and an ulnar tendinous plexus and two tendon loops. Data concerning intrinsic muscles, vessels and nerves are entirely recorded. Soft-tissue abnormal distribution is due to the abnormal bony configuration. Correction of the bone abnormalities does not resume the surgical treatment of a cleft hand. Hand surgeons need to be aware of the soft-tissue disorders and their surgical implications.
Durand
S
S
Institut d'anatomie des Saints-Pères, Centre du don des corps, Université René Descartes, 45 rue des Saints-Pères, Paris, France. sebdurand3@hotmail.com
Delmas
V
V
Fox
M
M
Hivelin
M
M
Oberlin
C
C
Guero
S
S
D000368:Aged; D002102:Cadaver; D006228:Hand Deformities, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D014057:Tomography, X-Ray Computed
Acta Orthop Scand. 1977;48(6):592-9
564593
Am J Hum Genet. 2000 Jul;67(1):59-66
10839977
J Hand Surg Am. 2004 Nov;29(6):994-1001
15576207
Development. 2008 Apr;135(7):1377-88
18326838
J Hand Surg Am. 1976 Jul;1(1):8-22
1021591
J Hand Surg Am. 1988 Sep;13(5):650-6
3241032
J Bone Joint Surg Am. 1964 Dec;46:1707-20
14239859
J Hand Surg Br. 1990 May;15(2):201-9
2164076