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Mirror hand and its management: a case report
V Ravi Kiran1, Udit K Jayant1, M L V Sai Krishna2
1Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Journal of Medical Case Reports
|November 29, 2024
Summary
Mirror hand, a rare congenital anomaly, involves limb malformation due to embryonic development issues. Early surgical intervention and planning are crucial for optimal functional and cosmetic outcomes in affected children.
Area of Science:
- Congenital Hand Anomalies
- Pediatric Surgery
- Embryogenesis Research
Background:
- Mirror hand is a rare congenital anomaly, often sporadic, linked to sonic hedgehog pathway defects during embryogenesis.
- This condition presents a significant surgical challenge, requiring specialized management strategies.
Observation:
- A 2.5-year-old child presented with Al Qattan type 1A ulnar dimelia, characterized by ulna duplication and polydactyly, impacting wrist and elbow mobility.
- Radiological assessment confirmed the duplication of the ulna and presence of polydactyly.
Findings:
- Successful surgical management achieved significant improvements in fine and gross motor skills.
- Acceptable cosmetic results were noted during the 2-year follow-up period.
Implications:
- Early intervention (18-24 months) is critical for optimal functional outcomes in mirror hand cases.
- Meticulous preoperative planning, surgical technique, and long-term follow-up with physical therapy are essential.
- Digital subtraction angiography is recommended to screen for associated neurovascular malformations.
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