The largest group of anomalies associated with shortened fingers is called symbrachydactyly. In this anomaly, the entire upper extremity may be foreshortened and somewhat smaller than the opposite side, but the fingers are the most severely affected. All of the digits may be affected or only the thumb. The most common type is the monodactylous type in which there is a deficiency of all the fingers except the thumb. These digits are often represented by small nubbins which have a tiny residual nail.
Treatments:
A variety of potential surgical options are available for identical digital amputations from the constriction band syndrome and for symbrachydactyly when multiple digits are hypoplastic. One might chose to ablate some of the shorter digital segments and transpose portions to adjacent digits in order to lengthen them. While this results in fewer than five digits in one hand, it positions those remaining digits for more functional grasping prehension, and augments the size of the remaining digits. Webspace widened and deepened and between hypoplastic digits will also not only create the illusion of longer digits, but also provide necessary functional lengthening and increased grip span. Other options for augmentation of hypoplastic digits include, toe-phalangeal bone grafting, distraction lengthening, and microvascular toe to hand transfer. In some of the more complex hand anomalies, where there are multiple short digits, one may need to rely on more than one of these reconstructive options and lay out a planned series of reconstructions in a logical order to ultimately reach the reconstructive goals. For example, a sequence of initial placement of toe-phalangeal bone grafts,
followed by webspace widening,
and then finally distraction lengthening,.jpg)
may provide the desired functional joints and digits with an appropriate grip span for grasping and manipulating objects.
