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The middle phalanges' (often those of the 2nd, 3rd and 5th digits of the hands) angel shape is caused by an abnormal development of the epiphysis, metaphysis, and diaphysis of said phalanges; the wings are formed by an abnormal dyaphysis, the angel's skirt is from a cone-shaped epiphysis, and the head is formed by an abnormal distal pseudoepophysis.
This deformity is caused by a widening of the epiphyseal plate of the fifth finger's distal phalange. [12] Another proposed cause involves the abnormal insertion of the flexor digitorum profundus in the volar area of the fifth finger's distal phalange. [13] It is thought to be an autosomal dominant trait with reduced penetrance. [14]
Gross clubbing – Thickening of the whole distal (end part of the) finger (resembling a drumstick) Hypertrophic osteoarthropathy – Shiny aspect and striation of the nail and skin; Schamroth's sign or Schamroth's window test (originally demonstrated by South African cardiologist Leo Schamroth on himself) [16] is a popular test for clubbing.
Osteoarthritis of the hand causes stiffness of the base of the thumb, alongside enlargement of DIP and PIP joints, leading to the formation of Heberden's nodes and Bouchard's nodes respectively. [6] Such firm and bony swellings at the finger joints are caused by the growth of osteophytes .
Triphalangeal thumb (TPT) is a congenital malformation where the thumb has three phalanges instead of two. The extra phalangeal bone can vary in size from that of a small pebble to a size comparable to the phalanges in non-thumb digits. The true incidence of the condition is unknown, but is estimated at 1:25,000 live births. [1]
Brachydactyly type D is a skeletal condition which exhibits a 'partial fusion or premature closing of the epiphysis with the distal phalanx of the thumb', according to Goodman et alia (1965). [6] J.K. Breithenbecher (1923) found that distal phalanges of short thumbs were one-half the length of full-length thumbs, while R.M. Stecher (1957 ...
At the level of the mid-proximal phalanx or mid-metacarpal, the distal component is transferred to the proximal component. The tendons of the distal component are preserved as the rest of the distal component is amputated. The neurovascular bundle which supplies the distal component is reserved and transferred proximally. [12]
Pycnodysostosis also causes problems that may become evident with time. Aside from the broken bones, the distal phalanges and the collar bone can undergo slow progressive deterioration. Vertebral defects may permit the spine to curve laterally resulting in scoliosis. The dental problems often require orthodontic care and cavities are common.