PEDIATRIC DIGITAL DEFORMITIES

Question 1

cleft foot (lobster foot, split foot); absence of 2 or 3 central rays

Absence of 2nd-4th toes & mets, giving a clef in the forefoot

Answer 1

Ectrodactyly

Question 2

supernumerary digits

Answer 2

Polydactylism, autosomal dominant!

Question 3

name this classification based on location of extra digit?

supernumerary digit on medial side of hallux or foot

Answer 3

Preaxial Polydactylism

Question 4

name this classification based on location of extra digit?

duplication of digits lateral to 2nd toe, 3rd toe, & 4th toe

Answer 4

Central Polydactylism

Question 5

name this classification based on location of extra digit?

supernumerary digit lateral to 5th toe

Answer 5

Postaxial Polydactylism

Question 6

name this classification based on tissue differentiation?

well-formed extra digit that articulates with the metatarsal

Answer 6

Type A Polydactylism

Question 7

name this classification based on tissue differentiation?

extra digit is not well-formed; looks like an extra digit skin tag

Answer 7

Type B Polydactylism

Question 8

name this classification based on tissue differentiation?

combo of A & B, partially formed toe w/ some bone or cartilage

Answer 8

Type M Polydactylism

Question 9

what is this association of polydactylism?

short limb to dwarfism w/ no trunk involvement; auto. recessive tibial hypoplasia, polydactyly of hand, congenital heart disease, septal defects

tibial hypoplasia, polydactyly of hand, congenital heart disease, septal defects

nail dysplasia

Answer 9

Ellis-van Creveld Syndrome

Question 10

what is this association of polydactylism?

causes low birth weight for gestational age

polydactyly, hypoplastic nails, 5th finger overlaps 4th clinodactyly

trisomy 13

Answer 10

patau syndrome

Question 11

primarily caused by a taut abductor hallucis

Secondary causes are short 1st met, metatarsus varus, & diastrophic dwarfism

Surgical correction is only treatment

Answer 11

Congenital Hallux Varus

Question 12

hitch hikers toe, club foot, & short limbs

Answer 12

Diastrophic Dwarfism

Question 13

local gigantism of digit due to genetic input (can be manifestation of systemic issue)

Associated w/…

Neurofibromatosis
Von Recklinghouse disease
Hyperplasia of lymphatics or adipose
Arteriovenous fistula
Increased circulation to the digit

Answer 13

Macrodactylism

Question 14

mutation in short arm of chromosome 17

Causes neurofibromatosis in 1 out of 3000

café au lait spots (6 or more in number, 5mm diameter)

Answer 14

Von Recklinghouse disease

Question 15

dorsal overriding 5th toe, hyperextended & adducted 5th toe across base
of normal 4th toe

Called clinodactyly in hand

• Stretching, strapping, splinting
• Surgery in adolescence

Answer 15

Congenital Digitus Minimum Varus

Question 16

(aka curly toe) toes are plantarflexed, medially deviated, & rotated laterally at DIPJ

-Bilateral & symmetrical
-Cause – hypoplasia of intrinsic muscles of the toe
o increased familial incidence
-Treatment – neglect, budding splinting, digital devices, MPC (moldable podiatric compound)

Answer 16

Varus Toe

Question 17

any degree of webbing or fusion of fingers or toes

cause-autosomal dominant

epidemiology-seen more so in males, toes 2-3 have the greatest frequency, zygodactyly most common

Answer 17

syndactyly

Question 18

name this conditions associated w/ syndactyly?

short toes

Answer 18

Brachydactyly

Question 19

name this conditions associated w/ syndactyly?

(acrocephalosyndactyly) growth disturbances in head, hands, & feet

Premature synostosis of cranium, synostosis of phalangeal joints, fusion of tarsal bones

Syndactylism of metatarsals & digits

Polydactylsm

Answer 19

Apert’s Syndrome

Question 20

name this conditions associated w/ syndactyly?

fusion of distal phalanges, asymmetrical breasts, & webbing of axilla

Answer 20

Poland’s Syndrome

Question 21

name this conditions associated w/ syndactyly?

(aka fibrous dysplasia) polysyndactyly, club foot, long bone dysplasia

Answer 21

Albright’s Syndrome

Question 22

name this Classification of syndactyly?

partial or complete webbing of the 2nd & 3rd toes

The most common syndactyly clinically

Usually a cosmetic problem

Answer 22

Type I Zygodactyly

Question 23

name this Classification of syndactyly?

syndactyly of lateral most 2 toes + polydactyly of the 5th toe

Usually a functional foot problem (not just cosmetic)

Answer 23

Type II Syncopolydactyly

Question 24

name this Classification of syndactyly?

fusion of metatarsals or metacarpals

Answer 24

Type V Metatarsals & Metacarpals

Question 25

long, slender, spider-like fingers; associated w/ Marfan Syndrome

Answer 25

Arachnodactyly

Question 26

flipper-like appendages due to Thalidomide exposure in the 1st trimester

Answer 26

Phocomelia