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Cleft Hand and Foot Syndrome: A Report of Three Cases with Review of Literature
Rajiv Kaul1, Neha Akhoon2, Manish Prasad1
1Department of Orthopaedics, Base Hospital Delhi Cantonment, New Delhi, India.
Insights
Cleft hands and feet, a rare congenital limb abnormality, can cause cosmetic and functional issues. This case series highlights a family with varying phenotypes, suggesting syndromic association, and advocates for non-operative management unless severe functional limitation exists.
Area of Science:
- Genetics and Developmental Biology
- Orthopedics and Rehabilitation
- Clinical Case Studies
Background:
- Cleft hands and feet are rare congenital limb abnormalities impacting development.
- These deformities present cosmetic concerns and potential functional deficits.
- Surgical reconstruction decisions pose ethical considerations for practitioners.
Introduction:
Cleft hands and feet constitute a rare, congenital abnormality of limb bud development, manifesting as a cosmetically and, occasionally, a functional debility of the hands or feet. Patients often pursue expert advice regarding the surgical reconstruction of their deformities, which may pose an ethical dilemma to the treating practitioner.
Case Report:
We present a case series of a family of three with bilateral cleft hands and feet, highlighting the dissimilarities in their phenotypic presentation. The clinical pointers indicate a possible syndromic association of ectrodactyly, ectodermal dysplasia, and clefting syndrome.
Management:
All patients were evaluated for the possibility of surgical reconstruction of their deformities, and were managed non-operatively in view of their satisfactory functional adaptation.
Conclusion:
The present report highlights the clinical features, diagnosis, and role of a multidisciplinary approach in the evaluation of this culturally disconcerting disorder. Surgery should be reserved for severe functional limitation in case of cleft hands and unadaptable cleft feet.
