The clinical features of clinodactyly are a deformed digit, usually the little finger, with radial deviation at the level of the distal interphalangeal joint. More rarely, there can be ulnar deviation. The digit may be shorter than expected. The other side may be affected. Usually, the deviation is noted at birth and worsens with growth.
The main concern of the patient or family is normally a cosmetic one. Rarely, there is a functional problem, for example the digit impinging on neighbouring digits during palmar flexion. Trauma may be the factor that instigates the first presentation; the patient may wrongly attribute deviation to the injury. The history may also reveal features of one of the syndromes which are associated with clinodactyly - see main menu.
On examination, the distal phalanx is deviated and the extent of angulation of the distal interphalangeal joint is measured with a goniometer. Equally, the range of active and passive motion at all digital joints is recorded. All other digits must be examined for synchronous hand anomalies. Given that a significant percentage of all clinodactyly cases are inherited, the parents of an affected child should be examined for a similar deformity.
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