Embryological development and prevalence of thumb flexion creases

A study of the embryological development and morphology of the thumb flexion creases is presented. We used 178 human fetuses, at 6-20 weeks of gestational age, and 225 normal adults, aged 19-81 years, to observe the morphology and the timing and location of the appearance of the flexion creases. Most creases, that is, the regular, extra, and oblique creases, were found to develop concurrently with the appearance of the fetal volar pads, apparently independently of the thumb flexion movements. Although the regular creases usually appear to be simple, single creases, they seem to be formed by the radial and ulnar lateral crease segments that develop inwards from each lateral side. Our observations also suggest that the oblique and extra creases on the proximal phalanx of the thumb should be considered as common or "regular" creases, rather than anomalies, because of their high frequency in fetuses and in normal healthy adults.