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Hand-foot-genital syndrome (HFGS) is characterized by limb malformations and urogenital defects. Mild bilateral shortening of the thumbs and great toes , caused primarily by shortening of the distal phalanx and/or the first metacarpal or metatarsal , is the most common limb malformation and results in impaired dexterity or apposition of the thumbs.
[3] [5] The third (middle finger) metacarpal head has been reported to be the most common site of necrosis. [6] Though osteonecrosis is a fairly common condition, many cases of avascular necrosis of the metacarpal head go without being diagnosed. This is because presentation of symptoms is variable depending on the patient.
Symptoms of isolated brachydactyly include shorter bones in the hands and feet. This could include, phalanges, metacarpals, metatarsals, carpals, and tarsals. Different types of isolated brachydactyly have different symptoms and they are grouped according to what areas they affect.
It is a feature of various rare disorders such as Apert's syndrome, and can occur alongside other isolated congenital hand/foot malformations including syndactyly, cleft hand, metatarsal synostosis, and polydactyly. [11] A syndromic form of syndactyly known as syndactyly type V has metacarpal and metatarsal synostosis as symptoms. [12]
Negative signs include a lack of obvious deformities, erythema, signs of inflammation, or limitation of movement.Direct pressure between the metatarsal heads will replicate the symptoms, as will compression of the forefoot between the finger and thumb so as to compress the transverse arch of the foot.
Symptoms may be treated by wearing wider shoes to relieve pressure, or the patient can wear padding around the toes. Surgery is also an option, if the pain and discomfort cannot be treated, or for cosmetic reasons. In this procedure, the short metatarsal is typically cut and a piece of bone is grafted between the two ends.
Bones of the right foot. Dorsal surface. Metatarsus shown in yellow. The base of each metatarsal bone articulates with one or more of the tarsal bones at the tarsometatarsal joints, and the head with one of the first row of phalanges at the metatarsophalangeal joints. Their bases also articulate with each other at the intermetatarsal joints
The index metacarpal is the most firmly fixed, while the thumb metacarpal articulates with the trapezium and acts independently from the others. The middle metacarpals are tightly united to the carpus by intrinsic interlocking bone elements at their bases. The ring metacarpal is somewhat more mobile while the fifth metacarpal is semi ...